Cleveland Clinic removes tumor from fetal heart, marking 2nd successful case globally

A team at Cleveland Clinic successfully removed a rare malignant tumor from the heart of a 26-week-old fetus. It's the second time such a case resulted in continued pregnancy and successful delivery. 

The nearly 3.5-hour surgery to treat the rare condition — an intrapericardial teratoma with fetal hydrops, or fluid accumulation — took place in May and the baby boy was delivered in July, the health system said Dec. 22. The mother and baby are both doing well, according to a news release. 

"Only one previous incidence of continued pregnancy and delivery after fetal intrapericardial teratoma resection is documented in the world's medical literature," said Darrell Cass, MD, director of Cleveland Clinic's Fetal Surgery and Fetal Care Center. "As far as we know, Cleveland Clinic is the second academic medical center in the world to have performed this fetal surgery successfully with continued pregnancy and delivery." 

The tumor had been compressing the left side of the fetus' heart and impairing circulation, which led to fluid buildup around the heart and other organs. 

Dr. Cass led the fetal surgery team during the procedure, and Hani Najm, MD, led the heart surgery team. During the procedure, which involved a Cesarean section-like incision to expose the mother's uterus, an IV line was placed into the fetus' right arm to deliver fluids and medications. Dr. Najm was then able to open the chest and pericardium and remove the tumor. 

"As soon as the tumor was removed, the compression of the left atrium disappeared, and there was a nice blood flow that was almost back to normal," Dr. Najm said. 

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