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First time in Israel: Cardiac catheterization on tiny baby

Medical team at Hadassah hospital successfully performs procedure on baby delivered in 26th week of pregnancy, weighing less than 2 pounds.

A cardiac catheterization, the first of its kind in Israel, was successfully performed this week at Hadassah Ein Kerem on a fragile premature infant. Born four weeks ago, together with her twin sister at Hadassah Mount Scopus, the tiny girl weighed one pound, delivered in the 26th week of pregnancy. When she gained a quarter pound, the procedure was scheduled.

She underwent a catheterization to close a central blood vessel . The large team was led by cardiologists Gavri Sagi, . Nurit Yaakobi, and .Gur Meintzer as well as neonatologists and anesthesiologists Noa Ofek and Shelly Stoll.

The baby’s condition is called PDA, Patent Ductus Arteriosus, which means that a child is born with an unclosed hole in the aorta. Before birth, blood doesn’t have to go to the lungs to be oxygenated. It goes through a hole that allows the blood to skip the circulation to the lungs. After birth, in a healthy heart, the blood must receive oxygen in the lungs and the hole closes with the first few days after birth. Failure of the ductus to close is common in premature infants but rare in full-term babies.

Normally the heart's left side only pumps blood to the body, and the right side only pumps blood to the lungs. In a child with PDA, extra blood gets pumped from the body artery (aorta) into the lung (pulmonary) arteries. This makes the heart and lungs work harder and the lungs become congested. Catheters are used so close the PDA, but until now, this had never been done with such a premature baby in Israel.

The catheterization requires inserting long thin tubes in the blood vessels in the leg to reach the heart and the PDA. A vascular plug is inserted through the catheters into the PDA. Without catherization, dangerous and complicated surgery must be done.

“Tiny babies have a hard time recovering from so surgery,” said Dr. Meintzer. Meintzer, director of Pediatric Catheterization Unit at Hadassah. The cauterization took the team four hours and was successful.

Dr. Yaakobi said the team has been acquiring the needed expertise at different hospitals and conferences around the world to be ready for the day when they would have to save a tiny premature baby with this heart defect.

The baby is recovering in the neonatal intensive care unit at Hadassah Mount Scopus.

"The catheterization was a breakthrough for our team, now allowing us in Israel to treat tiny premature babies who suffer from this problem, saving them from surgery,” says Dr. Meintzer.

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