Stephanie Hartman and her unborn son, Danny, are doing well after a team of physicians performed a successful in utero procedure at University Hospitals Rainbow Babies & Children's Hospital (UH Rainbow) last month. Known as fetal aortic valvuloplasty, this is the first heart procedure done before birth in Ohio.
Stephanie has been staying at the hospital until she's expected to be induced to give birth in six days.
This rare approach helps prevent the progression of hypoplastic left heart syndrome (HLHS) in about half of all treated patients. Babies born with HLHS are sometimes referred to as having half a heart, because the left chambers of the heart are too small to pump blood to the body. The minimally invasive procedure may make the baby healthier and more stable at birth and may decrease the number of open-heart surgeries for the child later in life.
"Right now, mom and baby are doing well, and we noted improvement in the way the blood flows through the heart prior to mom's discharge," says James Strainic, MD, Director, Fetal Heart Program at UH Rainbow.
The procedure took place at UH Rainbow through the Congenital Heart Collaborative's Fetal Heart Program, which offers cardiac interventions for unborn babies with developing HLHS and other critical, congenital heart conditions.
The fetal valvuloplasty uses ultrasound guidance and a catheter-based approach to gain access to the fetal heart and to open the aortic valve using a tiny inflated balloon. This increases blood flow through the left ventricle of the heart to help its development.
Aimee K. Armstrong, MD, Director of Cardiac Catheterization and Interventional Therapies at Nationwide Children's Hospital, has performed fetal heart procedures more than a dozen times in her career, but this is her first fetal intervention patient since joining the Congenital Heart Collaborative in 2015. Dr. Armstrong built a team of experts from Nationwide Children's, UH Rainbow and UH MacDonald Women's hospitals, as part of the Congenital Heart Collaborative.
"By performing interventions on the fetal heart, we are able to alter the trajectory of heart and lung disease development before a baby is born with the goal of making the baby's heart healthier at birth," said Dr. Armstrong. "We ultimately hope to be able to decrease morbidity and mortality for these babies."
The Congenital Heart Collaborative, formalized two years ago, is a partnership between UH Rainbow Babies & Children's in Cleveland and Nationwide Children's in Columbus, which brings together expert physicians, surgeons and teams to provide world class care for patients and families in Northeast Ohio.
"The Fetal Heart Program at UH Rainbow Babies & Children's Hospital is proud to be the first site in Ohio to offer this state-of-the-art care for babies who are diagnosed with a congenital heart condition before birth," said David Hackney, MD, Division Chief of Maternal Fetal Medicine at UH MacDonald Women's Hospital. "Our goal is to provide comprehensive care, from initial diagnosis through the entire pregnancy and beyond."
With UH Rainbow Babies & Children's and UH MacDonald Women's hospitals both under one roof, Maternal Fetal Medicine specialists and the Congenital Heart Collaborative team can offer the full continuum of care in rare cases like this, for optimal outcomes.
When the baby is born, he will receive immediate follow-up care from experts at UH Rainbow Babies & Children's Hospital and the Congenital Heart Collaborative.
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