A team of more than 20 specialists at WMCHealth’s Maria Fareri Children’s Hospital and Westchester Medical Center successfully performed a complex, first-of-its-kind open-heart surgery on a newborn while he remained partially inside his mother’s womb. The procedure marks a significant advancement in neonatal cardiac care and offers a new approach to treating severe congenital heart defects.
IMAGE Via – WMCHealth’s Maria Fareri Children’s Hospital
A Critical Diagnosis and Limited Options
Megan Wild of Chester, N.Y., learned at 20 weeks pregnant that her unborn son, Luciano Reynaga, had hypoplastic left heart syndrome (HLHS), a congenital defect that results in an underdeveloped left side of the heart. Typically, HLHS is managed through a series of surgeries after birth, but Luciano’s condition was complicated by the absence of necessary communication between the right and left sides of his heart. This increased his risk of mortality immediately after delivery, leaving few viable options for intervention.
Given the severity of the diagnosis, Megan and her medical team opted for an innovative surgical approach that had been attempted only twice before worldwide—both without success.
A Pioneering Surgical Approach
The procedure, led by Dr. Sameh Said, involved the ex-utero intrapartum treatment (EXIT) technique, in which the 38-week-old baby was partially delivered via Cesarean section but remained attached to the placenta and umbilical cord. This setup allowed the mother’s body to continue supplying oxygen, stabilizing the newborn without the immediate need for mechanical life support.
While the baby remained partially within the womb, Dr. Said performed an open atrial septostomy (OAS) to establish blood flow between the right and left sides of the heart. Once circulation was improved, Luciano was fully delivered weighing a healthy 8 lbs. and 1 oz. This marked the first documented case where the EXIT and OAS procedures were successfully completed together.
Post-Surgical Care and Recovery
Following the initial operation, Dr. Said performed a second procedure—the Norwood operation—within 24 hours to further reconstruct Luciano’s heart and improve its function. After a carefully monitored post-operative stay in Maria Fareri Children’s Hospital’s pediatric intensive care unit, Luciano is now recovering and expected to be discharged soon.
“Being a mom is wonderful,” Megan said. “I was so scared to give birth because I didn’t know what was going to happen, but the first time I held my son was incredible.”
Although Luciano will require additional surgeries as he grows, his medical team remains optimistic about his long-term prognosis.
The success of this procedure was the result of extensive coordination among specialists in maternal-fetal medicine, pediatric cardiac surgery, pediatric cardiology, anesthesia, and neonatal medicine.
“The advanced capabilities of Maria Fareri Children’s Hospital allowed us to undertake this highly complex procedure,” said Dr. Erika Rosenzweig, Physician-in-Chief of Maria Fareri Children’s Hospital. “Through meticulous planning and collaboration, we were able to provide Megan and Luciano with a life-saving intervention that had never been accomplished before.”
This breakthrough not only represents a milestone in neonatal cardiac surgery but also expands future possibilities for treating severe congenital heart conditions in newborns.
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