UH Rainbow Performs Innovative Fetal Heart Procedure In Utero

Heather Catanese was 22 weeks pregnant with her third son, Lorenzo, when a routine prenatal test showed that something was wrong – blood was flowing in the wrong direction through her baby’s heart. Lorenzo was diagnosed with impending hypoplastic left heart syndrome (HLHS), a complex congenital heart defect in which the left side of the heart does not fully form.

“Babies with this condition are born with half a heart,” explained James Strainic, MD, Director of the Fetal Heart Program at UH Rainbow Babies & Children’s Hospital. “The left chambers of the heart are too small to pump blood to the body.” Lorenzo’s case was particularly severe and was impairing his left heart valve. The outcomes for babies with this combination of problems are grim. They have about a 10 percent chance of surviving to six months.

Dr. Strainic, however, proposed an innovative procedure that could be done while Lorenzo was still in utero. Using ultrasound guidance, a needle could be placed through Heather’s abdomen into Lorenzo’s heart, allowing physicians to insert a balloon in Lorenzo’s aortic valve. “The goal is that increased blood flow through the left ventricle will aid the development of the left side of the heart and prevent HLHS,” said Dr. Strainic.

The Congenital Heart Collaborative at UH Rainbow is one of only eight centers nationwide that offers the procedure and the only provider of this type of care in Ohio.

Heather and her husband, Anthony, had a lot of questions and met with numerous UH Rainbow physicians to discuss the plan. They also received opinions from teams in other parts of the country that had performed the same procedure. “We decided to move forward with the team at UH Rainbow,” said Heather. “We felt like no other team of doctors was as invested in our baby as the team here at UH.”

On February 7, 2018, at 24 weeks of pregnancy, Heather successfully underwent the procedure at UH Rainbow with a multidisciplinary team of experts in maternal fetal medicine, fetal cardiology and pediatric interventional cardiology. The remainder of her pregnancy progressed smoothly and, on May 18, Lorenzo was born.

“There were so many unknowns,” said Heather. “We didn’t know how his heart would function outside of the womb.” But after just four days in the NICU for observation, Lorenzo went home. He continues to receive monthly echocardiograms with Dr. Strainic but is, by all accounts, a healthy baby boy.

“We are so thankful for the Congenital Heart Collaborative team who not only saved our son’s life, but have given him a higher quality of life than we could have hoped for,” said Heather. “I can already tell that he’s going to try to keep up with his big brothers. We couldn’t have asked for a better outcome.”