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Open Fetal Surgery for Lung Masses/CCAM
In rare instances, open fetal surgery may be required to save the life of a fetus with a very large lung mass. Whereas most fetuses with lung masses do not require treatment, in rare cases, fetal treatment may be required. In unusual cases, the lung mass, which may be a CCAM or other lung abnormality, grows rapidly to a large size.
It may compress the heart, which can prevent adequate blood flow, and lead to a condition known as fetal hydrops and eventually to signs of fetal heart failure. In some conditions, findings of fetal hydrops may not be associated with fetal heart failure. In these cases, fetal treatment may not be required. If there is evidence for fetal heart failure, then it is likely that the fetus will not survive unless some type of treatment is performed.
Treatment options include aspiration or placement of a shunt (thoracoamniotic shunt), if large cysts are present within the mass, an open fetal surgical removal of the mass may be an option.
During open fetal surgery, the mother’s abdomen and uterus are opened. The fetal chest is opened and the lung mass removed, and then the fetal chest, uterus and mother’s abdomen are closed. There are risks to this procedure, and these risks need to be carefully balanced for each individual mother and family.
Presently, Texas Chldren’s Fetal Center is one of only three places in the world to have successfully accomplished open fetal surgery for a fetus dying from a lung mass, or CCAM.