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Milan, extraordinary heart surgery on a 15-month-old girl

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Operated at the IRCCS Policlinico San Donato in Milan, little Matilde returned home, the newborn who underwent heart surgery in February that allowed her to definitively correct the complex congenital heart disease she suffered from. It is the first intervention of its kind in the world

Extraordinary intervention at the IRCCS Policlinico San Donato in Milan: little Matilde, the 15-month-old girl who underwent heart surgery in February that allowed her to definitively correct the complex congenital heart disease she suffered from. The little girl had been followed in utero at Vittore Buzzi Hospital, with which the IRCCS has a long-standing collaboration agreement, with prenatal diagnosis of Congenitally Correct Transposition of the Large Arteries (CCTGA), Interventricular Septal Defect (DIV) and Ebstein’s On the Tricuspid Valve. Since the neonatal period, after 20 days of life, the newborn had undergone a first operation to protect the pulmonary artery (with further reduction at two months), a preliminary procedure for cardiac surgical correction. When, at 15 months old, she reached a weight suitable to support the operation (between 8 and 10 kg), the still young child was admitted to the hospital of the IRCCS Policlinico San Donato, to receive a modified double switch, one of the few ever made in the world. An atrial and arterial switch and a simultaneous Hemi-Mustard and Glenn (BDG) with closure of the interventricular defect (DIV) were performed. In this way, not only was the pulmonary artery reconnected to the right ventricle and the aorta reconnected to the left ventricle and the connection between the systemic and pulmonary circulation was restored, but the hole in the wall separating the two was also closed . of the heart.

Discharge after 15 days

The operation was performed with extraordinary success, so much so that after the operation the little girl was hospitalized for only 15 days, of which 5 were in intensive care and 10 days in the ward. Throughout the journey, the child was followed by Dr. Antonio Saracino, Chief of the Department of Clinical Pediatric Cardiology at the IRCCS Policlinico San Donato. The cardiac-child surgery department of the IRCCS Policlinico San Donato is the first center in Italy and one of the most active centers in Europe for the diagnosis and treatment of congenital heart disease. About 500 cardiac surgeries are performed each year to treat congenital heart disease, in addition to the more than 600 patients treated with interventional cardiology procedures.

Very complex intervention

“We had two options, either very complex anatomical correction, which completely resolved the pathological image of the child, or a less risky intervention, physiological correction, which would not have completely resolved the anatomical problem, and therefore with perspective for the child, of having to undergo other surgical procedures after a few years that were never definitive. We courageously chose the first path, strengthened by the expertise for highly complex pediatric cardiac surgery at the IRCCS Policlinico San Donato and strengthened by the trust of the child’s parents who have completely entrusted themselves to us,” said Dr. Alessandro Varrica, surgeon of Pediatric and Adult Congenital Cardiac Surgery, led by Dr. Alessandro Giamberti.

First case in the world

The operation was the first in the world, of such high complexity, to be performed with a new state-of-the-art perfusion system of the latest generation that the IRCCS Policlinico San Donato had recently tested for the first time in the pediatric field, indicated in particular because it reduces the risk of exposure to long periods of extracorporeal circulation, as related by Dr. Mauro Cotza, head of the perfusion service and of the ECMO unit of IRCCS Policlinico San Donato.

Source: TG 24 Sky

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