First Successful Procedure of Its Kind in Medical History; Novel Surgical Solution to Deadly Congenital Heart Defect Performed Minutes After Birth at Maria Fareri Children’s Hospital
VALHALLA, N.Y. (February 21, 2025) – A team of more than 20 medical specialists from WMCHealth’s Maria Fareri Children’s Hospital and Westchester Medical Center successfully performed a landmark, lifesaving open-heart surgery on a minutes-old baby, using the baby’s mother as a life-support system during the procedure.
Megan Wild of Chester, N.Y., was 20 weeks pregnant when her unborn son was diagnosed with hypoplastic left heart syndrome, a rare congenital heart defect that results in an underdeveloped left side of the heart. The defect leads to high mortality rates immediately after birth in afflicted babies, as the baby’s underdeveloped heart cannot pump oxygen-rich blood to the body.
Surgery to address this defect typically involves three stages, the first of which is performed in the first week of life. Most babies with this condition can survive after birth until their first surgery due to open communication between the right and left sides of the heart. However, Megan’s baby had no communication between the right and left sides of the heart, which created added challenges and an extremely elevated risk of death for the baby if she went ahead with standard delivery.
Faced with the emotional decision of how to save the life of her unborn child, Megan put her trust in the hands of WMCHealth’s surgical specialists by choosing to proceed with a complex surgery—one that has only been performed twice in worldwide medical history, neither of which were successful.
Here’s How the Landmark Surgery was Performed
During the complex, multi-step procedure, Westchester Medical Center advanced OB-GYN surgeons Geetha Rajendran, MD, and Angela Silber, MD, in collaboration with Maria Fareri Children’s Hospital’s pediatric cardiac surgery team, led by Sameh Said, MD, performed ex-utero intrapartum treatment (EXIT) surgery. In this procedure, Megan’s baby was partially delivered via Caesarean section while the placenta and umbilical cord remained intact. This crucial connection allowed Megan to function as her baby’s heart-lung machine, keeping the baby alive and ending the need for mechanical bypass support in the first hours of life.
While this life-saving connection remained in place and with the baby still partially within his mother, Dr. Said delicately and precisely operated on the newborn’s heart to improve blood flow between the right and left sides (open atrial septostomy or OAS). Once blood was successfully flowing through the baby’s heart, he was fully delivered.
Successful Heart Surgery a World First
Dr. Said’s skilled work to correct hypoplastic left heart syndrome during EXIT is truly novel as this was the first time the EXIT and OAS procedure was completed successfully in recorded medical history.
“In this case, the chance of Megan’s son surviving after a traditional birth and waiting until we performed the surgery to correct the defect was very slim. Even the transfer of the baby to another operating room or to our cardiac catheterization laboratory carried extremely high risks,” said Dr. Said. “Allowing the baby to remain bonded to Megan while we operated on his heart was critical in ensuring he had enough oxygen to support and stabilize his body through this emergent procedure.”
A Promising Future
Megan’s miracle baby, Luciano Reynaga, III, was born nearly full-term at 38 weeks, weighing 8 lbs. and 1 oz. Dr. Said completed a second surgery that rebuilt Luciano’s aorta and converted his right ventricle into a pumping chamber (Norwood procedure) less than 24 hours later.
After an uneventful post-operative stay in Maria Fareri Children’s Hospital’s pediatric intensive care unit, Luciano is now recovering well at a children’s rehabilitation facility and expected to be home soon.
“Being a mom is wonderful,” said Wild. “I was so scared to give birth because I didn’t know what was going to happen, but the first time I got to hold my son was magical. He’s so cute.”
Despite the challenges he faced at birth, Dr. Said is optimistic about Luciano’s future.
“He will need additional follow-up heart surgeries to achieve normal oxygen saturation. But due to the success of this surgery, we expect Luciano to have a good quality of life.”
Symphony of Care Leads to Successful Outcome
“The success of this groundbreaking procedure was truly a team effort, and an example of the advanced care capabilities of Maria Fareri Children’s Hospital,” said Erika Rosenzweig, MD, William Russell McCurdy Physician-in-Chief of Maria Fareri Children’s Hospital. “The complex surgery required weeks of careful prenatal planning and coordination from advanced care specialists at both WMCHealth’s Maria Fareri Children’s Hospital and Westchester Medical Center. The multidisciplinary team, consisting of experts in maternal-fetal medicine, pediatric cardiac surgery, pediatric cardiology, anesthesia, and neonatal medicine, worked seamlessly to ensure the best possible outcome for Megan and Luciano. We are incredibly thankful to Megan for trusting our skills and allowing us to care for her and her son.”