Pregnancy in October, once born, this is one of the happiest moments of parents. But it was a thrilling journey for the Kali couple in Yili, Xinjiang province. Prenatal examination found that the fetus had a severe complex congenital heart disease, complete transposition of the great arteries, and may die at birth. It was like a bolt from the blue that brought them to the brink of collapse. With the last glimmer of hope, they traveled from Xinjiang to Shanghai. At Children's Hospital of Fudan University, the cardiac surgery team has given the child a "second life". "Director Zhang, thank you very much. It was you who explained and consoled us over and over again, telling us that 'this is not a dead end, as long as we cooperate with the treatment, the child has hope'. Now that the baby can be safely discharged from the hospital, our family all feel that this journey of thousands of miles is worth it!" Mr. Kali clasped Director Zhang Huifeng's hands and said with emotion.
Recently, two children with complex congenital heart disease (complete transposition of the great arteries with intact ventricular septum, TGA/IVS) were successfully recovered and discharged from the hospital after active treatment by the expert team of Ming Ye and Huifeng Zhang, director of Cardiac Surgery of National Children's Medical Center and Children's Hospital of Fudan University.
Zhang Huifeng, deputy director of the Department of Cardiac Surgery, introduced that complete transposition of the great arteries is a critical congenital heart malformation, in which the aorta and pulmonary artery of the child are misconnected, causing the systemic and pulmonary circulation to go their own way and lose their exchange function, like misconnecting the positive and negative power supplies. Without timely intervention after birth, the infant is likely to die due to severe hypoxemia and cardiac insufficiency.
"Will my baby be delivered safely?" Children's Hospital of Fudan University and Obstetrics and Gynecology Hospital of Fudan University have carried out a seamless integrated management and multidisciplinary collaboration from prenatal to postnatal period to answer the common questions of expectable parents. During pregnancy, the fetal ultrasound team of the Obstetrics and Gynecology hospital accurately diagnosed the complex cardiac structural abnormalities present in the fetus. After that, a team of neonatologists, cardiac surgeons, and obstetricians and gynecologists conducted multidisciplinary discussion (MDT) and prenatal consultation, comprehensively evaluated the fetal prognosis, and formulated a detailed perinatal management strategy and postnatal treatment plan in advance.
Two expectant mothers were admitted to the obstetrics and gynecology hospital early according to the protocol before the due date of delivery. On the day of delivery, the medical team strictly implemented the established plan and completed the "fire rescue" relay. The neonatal transport team of Fudan Children's Hospital was on standby outside the delivery room. As soon as the baby was born, it was transferred to the neonatal intensive care unit of Fudan Children's Hospital.
After the cardiac surgery team fully evaluated the cardiac function and hemodynamic status of the neonates, the expert team of Ye Ming and Zhang Huifeng performed Arterial Switch Operation (ASO) on August 29 and September 15, respectively, for the two neonates who were three days and seven days old. The operation went smoothly, and the wrong life "power supply" was finally corrected. Recently, both children have recovered and been discharged from hospital. Zhang Huifeng, deputy director of the Department of Pediatric cardiothoracic Surgery, Fudan University, said that complete transposition of the great arteries is a severe and curable congenital heart disease. Although there are risks in surgery, most of them have an ideal prognosis and can grow up like normal children.
The Cardiovascular Center of Children's Hospital of Fudan University has treated more than 100 children with complex congenital heart disease through prenatal and postnatal integrated management process. This treatment model not only brings life hope to more families, but also lays a solid foundation for a good long-term prognosis of more children with complex congenital heart disease.
In the future, Fudan Pediatrics Department will continue to strengthen the cooperation with obstetrics and gynecology hospitals to further improve the prenatal screening, perinatal management and postpartum integrated treatment system of fetal heart disease, and promote the early diagnosis, early treatment and precise development of fetal and neonatal heart disease in China.