In a rare, delicate, and ultimately lifesaving surgery, an unborn baby was partially removed from his mother’s womb at 26 weeks so that a tumor growing on his heart could be removed. He was then placed back in his mom’s womb for a further 10 weeks before being born at nearly full term.
Baby Rylan Harrison Drinnon was diagnosed in the spring of 2021 with intrapericardial teratoma with fetal hydrops in utero, an extremely rare condition leading to heart failure if left untreated, according to the statement.
“As far as we know, Cleveland Clinic is the second academic medical center in the world to have performed this fetal surgery successfully with continued pregnancy and delivery,” said Dr. Darrell Cass, director of Cleveland Clinic’s Fetal Surgery and Fetal Care Center.
“In this case, time was of the essence. Shortly after the patient arrived at Cleveland Clinic, imaging tests showed that the tumor kept growing and the fetus’s heart function was deteriorating.”
The malignant mass was compressing the left side of unborn baby Rylan’s heart, cutting off circulation and leading to an accumulation of fluid around his heart and other organs.
Parents Sam and Dave Drinnon of Pittsburgh were referred to Cleveland for their expertise, said Cass. A multidisciplinary team from Cleveland Clinic and Children’s Clinic performed surgery in May 2021 to remove Rylan’s tumor.
After making a “Caesarean section-like incision” to expose the mother’s uterus, the team, led by Dr. Hani Najm, Cleveland Clinic’s chair of pediatric and congenital heart surgery, used ultrasound to locate the placenta and fetus. They opened the uterus and lifted out Rylan’s arms to expose his chest. Najm removed the tumor from the baby’s beating heart before placing him back in the uterus, in a surgery lasting 3 1/2 hours.
“As soon as the tumor was removed, the compression of the left atrium disappeared, and there was a nice blood flow that was almost back to normal,” Najm reported.
Both mom and baby recovered well, and Rylan was able to remain in the womb until near full term, according to the statement.
Maternal-fetal medicine specialist Dr. Amanda Kalan, who attended the surgery, oversaw Sam’s aftercare and the delivery of her healthy baby boy by C-section on July 13, 10 weeks after the surgery.
Cass expressed pride in his team for their massive success.
“This tumor was growing rapidly in the exact wrong spot,” Cass explained. “We needed to act quickly and decisively to rescue the fetus ... as far as we know, Cleveland Clinic is the second academic medical center in the world to have performed this fetal surgery successfully, with continued pregnancy and delivery.”
Only one previous incidence, said Cass, has ever been documented in the world’s medical literature.
Najm claimed that such innovative fetal surgery “provides hope to other families who may receive a similar devastating diagnosis.”
Looking to the future, Rylan will likely need surgery to reposition his sternum, which did not heal properly in the womb. Doctors will monitor his heart health as he grows to ensure the tumor does not reappear.
The Drinnons are beyond grateful for the lifesaving intervention.
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