The News Herald (Willoughby, OH)
Medical procedure gives baby a chance
Twenty years ago, baby Lorenzo’s multiple heart defects likely would have cut short his young life.
So say doctors who performed an innovative and uncommon surgery on now 8-months-old Lorenzo while he was still being carried in his mother’s womb.
After an exam during Heather Catanese’s 22nd week of pregnancy, she learned that the left side of the child’s heart was not functioning properly. The diagnosis was threefold: severe aortic stenosis, severe mitral regurgitation and evolving hypoplastic left heart syndrome.
“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,” according to information from UH Rainbow Babies & Children’s Hospital. “Not only did this fetus have developing HLHS, but he also had severe leakage of another heart valve.
“Statistics show that babies with this combination of defects have a 10 percent chance of survival to 6 months of age.”
Once the unfortunate news was given, Heather said that she and her husband Anthony, who live in Chardon, had few expectations for a full-term, healthy baby.
“It didn’t seem like there would be a viable outcome. It was very difficult to go over the what-ifs,” she recalled.
Dr. James Strainic, director of the Fetal Heart Program at UH Hospitals Rainbow Babies & Children’s Hospital, explained to them that Lorenzo’s condition was “one of the worst possible combination of problems - the blockage of one valve and the severe leakage of another,” the Cataneses were given a glimmer of hope.
Doctors informed the couple of a congenital Heart Collaborative comprised of a partnership between Rainbow and the Nationwide Children’s Hospital in Columbus which is able to perform a unique in-utero procedure named Fetal Aortic Valvuloplasty that could possibly improve their unborn son’s condition.
However, first it was necessary to determine if Lorenzo was a possible candidate. Next, the Cataneses needed to decide if they were willing to take the risk as the rarely performed operation did not ensure success.
Armed with information that their son was suitable for the procedure as well as extensive knowledge gleaned though research done by the couple, they chose to move ahead in hopes that the Aortic Valvuloplasty would help to bring about his live birth.
Optimally, the minimally invasive fetal procedure is to attempt to reverse the developing HLHS and decrease the number of open heart surgeries for the child later in life, according to Dr. Aimee K. Armstrong, director of Cardiac Catheterization and Interventional Therapies at Nationwide.
However, the Catanese family was only hoping “to give him a chance at life. To meet him, to hold him, to meet his brothers,” Anthony said.
Any additional positive outcome would be a precious bonus.
The procedure proved to be a success and weekly ultrasounds revealed continuous improvement throughout the remainder of Heather’s pregnancy.
On May 18, Lorenzo was born and placed in his mother’s waiting arms.
“That was a big win for us…the fact that they let me hold him,” Heather said. “He was doing so well. These were all happy moments.”
The only other surgery Lorenzo has needed thus far was a balloon procedure performed when he was 3 weeks old and he also responded well to that. He continues to be tested regularly and no other problems have arisen.
The active, normally developing infant sits, crawls and loves watching his brothers Gianni, 6 and Luca, 5, at play.
“He will turn his body and flip around to be with his brothers. He wants to be right in the mix,” Heather said.
Because the fetal procedure is technically experimental, insurance does not cover its cost. Eventually, with more cases being completed, the Cataneses hope that coverage will be approved.
In the meantime, they have initiated a Benevolent Fund, The Fetal Heart Foundation, to raise money for the Congenital Heart Collaborative at UH Rainbow Babies & Children’s Hospital.
The first event is scheduled for July 27 at the Cleveland Museum of Natural History.
At this point in time gratitude ranks high on their priority list.
“I am so thankful that we’re here in this city with this amazing health care, to be at the hospital with the team,” Heather said. “Not even a lot of doctors know about this procedure.” Anthony agrees. “I feel so blessed and fortunate that people are doing this procedure and giving babies like Lorenzo a chance at life,” he said.