When Brailey and Louis Valenzuela found out they were expecting their second child, a girl, they were overjoyed.
They chose a name, Arley, and enjoyed an “easy pregnancy” for about six months.
However, an ultrasound at 24 weeks revealed a life-threatening complication: Baby Arley had an olive-sized tumor in her heart known as a pericardial teratoma.
They were informed that the tumor would kill her if left untreated, and that it would grow so large that it would crush her heart under its weight.
Handing Arley over at that moment would put his life at risk. At 24 weeks, her organs were still developing and her chances of surviving outside the womb were low, so the Tennessee mother was referred to a team of specialists in Pennsylvania who have pioneered a procedure that allows them to operate at baby. while still inside his mother to eliminate the mass in your heart.
During surgery to remove the mass, doctors cut into the mother’s stomach and partially removed Arley from the womb, arms first, so that her chest was exposed.
They always try to keep as much of the baby as possible inside the mother to maintain the protective environment that the womb provides.
With the baby in that position, they were able to make an incision in her chest.
Arley recently visited his local cardiologist and is doing so well that he doesn’t need to return for another year.
Doctors partially removed Arley from her mother’s womb by piercing the amniotic sac, but did not give birth to her completely, keeping her protected in the fluid. Specialized devices maintained amniotic fluid levels to minimize risks, preventing the uterus or placenta from reacting to the surgery.
Next, they removed the tumor located within the membrane surrounding the heart.
After surgery, both mother and fetus are closely monitored for signs of recovery and for possible complications.
Mrs. Valenzuela said Today.com She was at Children’s Hospital of Philadelphia (CHOP), where doctors removed the tumor, for about two months until her daughter was born healthy and happy.
Pericardial teratoma in fetuses is fatal. TO third of cases cause the death of the fetus.
The condition is rare, occurring in about 0.07 to 2.8 in every 1,000 pregnancies. Between 2000 and 2020, only 55 fetal pericardial teratomas were reported worldwide.
CHOP has performed the procedure to remove it in the womb in four babies. It is difficult to pinpoint exact statistics on the number of activities carried out annually in the United States.
They are very rare and are typically performed in centers with doctors experienced in fetal surgery, making it difficult to track the exact number of procedures performed each year.
In total, the procedure took about an hour. It was a team effort, including specialists from cardiology, fetal surgery, maternal-fetal medicine, cardiovascular surgery, anesthesiology, neonatology and psychology, as well as a special group of fetal nurses.
Brailey Valenzuela, 32, didn’t suspect anything was wrong with her pregnancy. She and her husband were excited to meet their second daughter.
But the 24-week ultrasound changed everything.
Doctors at Covenant Health’s Fort Sanders Perinatal Center in Knoxville confirmed there was a tumor on her daughter’s heart.
Mrs Valenzuela said: “We were told several times that the outlook is bleak and that if something is not done soon, within days, the baby could die.”
A Tennessee cardiologist sent Ms. Valenzuela’s medical records to Children’s Hospital of Philadelphia, where doctors often treat complicated and life-threatening pregnancies.
“It was very fast,” Brailey Valenzuela said.
“They said, ‘The doctors have reviewed your file and think they can help you.’ It was a big relief.”
When they arrived in Philadelphia in December 2023, doctors had to act quickly and perform a series of tests, including additional ultrasounds.
Within 12 hours, Mrs. Valenzuela was in surgery.
Dr. Jack Rychik, one of the doctors involved in Brailey Valenzuela’s surgery, said fetal tumors like this are “pretty rare.”
The tumor, if left unchecked, could grow so large that it would crush Arley’s heart, killing her.
He said: ‘It’s a tumor that is growing wildly because very young cells… are misbehaving. (They) could have become different organs but they are still immature and decide to grow on their own.
“The concern about pericardial teratoma is that it is growing rapidly and uncontrollably in a very small space.”
Doctors partially removed Arley from her mother’s womb by piercing the amniotic sac, but they never fully delivered her, meaning she was never exposed to the air and primarily protected by the fluid that was there. Surgeons say that one of their main goals, in addition to removing the tumor, is to disturb the surrounding tissues as little as possible.
Doctors used specialized devices to keep amniotic fluid levels stable in the uterus, minimizing the risk of the uterus or placenta “feeling” the surgery.
When Brailey and Louis Valenzuela of Knoxville, Tennessee, found out they were expecting their second child, a girl, they were overjoyed. But an ultrasound at 24 weeks revealed her baby had a tumor the size of an olive in his heart.
The body can naturally induce labor in response to interruptions, but these devices, along with anesthesia techniques, help prevent contractions, labor, or changes in blood flow by ensuring that the uterus maintains its shape and fluid levels during labor. procedure.
Without intervening when they did, the mass in Arley’s heart could have grown so large, perhaps two to four times larger than the heart, and pressed against it, preventing it from filling with blood.
Dr. Rychik said, “You can’t survive if your heart can’t fill.” “That’s what makes these tumors lethal.”
Arley weighed only 1.8 pounds while this was happening.
Arley was born at 35 weeks, which is considered premature. But the surgery was a great success. The heart of the heart functioned normally.
Ms. Valenzuela gave birth by cesarean section in February 2024. Doctors discovered that her uterine lining was very thin and could tear if they did not deliver Arley at that time.
While removing the tumor, surgeons saw that it was loosely attached to the aorta, the largest artery in the body that carries oxygen-rich blood from the heart to the rest of the body.
After removing the tumor and repairing the tear left in the aorta, doctors stitched Arley back up, returned her to her mother’s uterus, and closed Brailey’s abdomen.
When she woke up, Mrs. Valenzuela looked for her husband and, dazed, pointed to her belly as if asking if Arley survived.
She said: ‘I remember him saying: “The baby is fine. “The baby is fine.” “That’s all I needed to hear… it was such a blessing.”
Arley is healthy and happy. His mother says his heart works like any other baby’s.
Within days, Arley’s heart began to function normally. Meanwhile, Mrs. Valenzuela remained in Philadelphia, where she was under strict surveillance until she gave birth. When, on February 17, 2024, she began experiencing severe abdominal pain, doctors discovered that her uterine lining was very thin.
To avoid a rupture, they delivered Arley via C-section at 35 weeks, which is considered premature.
Mrs Valenzuela said: ‘His heart was great. He’s functioning like any other baby.
Arley recently visited his local cardiologist and is doing so well that he doesn’t need to return for another year.
“It’s very good,” said Mrs. Valenzuela.
“I hope people can have hope when they read Arley’s story.”