Saudi Gazette report

RIYADH – A medical team at Cleveland Clinic hospital in Ohio, United States performed a rare and complex lifesaving fetal surgery to remove a tumor attached to the heart of a 26-week-old fetus inside his mother’s womb.

A video clip posted by Cleveland Clinic showed a simulation of the surgery performed by a multidisciplinary team, led by Saudi doctor Hani Najm and Dr. Darrell Cass. The clinic posted the video months after the successful operation and birth of the baby who is in good health.

The video became an instant hit on the social media with many twitteratis responded that they are immensely proud of this distinguished feat, scored by Najm, while lauding him as a role model for future generations.

For his part, Dr. Najm tweeted: “I am happy that I was able to remove, along with the surgical team at Cleveland Clinic, a cancerous tumor from the heart of a 5-month fetus in his mother’s womb and return the fetus to the womb, to complete the pregnancy until birth,” he said.

Dr. Najm wins accolades for remarkable feat

Renowned Saudi writer and former member of the Shoura Council Dr. Soraya Al-Arid joined several Saudi social media users in congratulating the outstanding achievement of Dr. Najm.

In a statement on her Twitter account, she said: “Our hearty congratulations to Dr. Hani Najm. We all are proud of you and your outstanding achievements. I still remember the occasion when we all were sitting together while the Crown Prince and the ministers were announcing the Kingdom’s Vision 2030 and the Transformation Program. We look forward to achieving such amazing results for the Vision,” she said.

Cleveland Clinic has become the second academic medical center in the world to have performed this fetal surgery successfully with continued pregnancy and delivery. Sam Drinnon, the American woman underwent fetal interventional surgery at Cleveland Clinic on May 7, 2021.

After the successful surgery, she maintained a healthy pregnancy for about 10 weeks. At 36 weeks and two days, her son, named Rylan Harrison Drinnon, was delivered by C-Section on July 13, 2021, weighing 6 pounds, 4 ounces.

In a statement, the clinic explained the remarkable achievement made by its medical team, led by Dr. Najm and Cass. According to the statement, the woman first “met” her unborn son, Rylan, about 10 weeks before her delivery.

Surgeons performed a life-saving procedure by removing the tumor growing on his heart.Najm recalled the amazing experience of leading the surgical removal of the tumor. “Imaging revealed the tumor was compressing the left side of the fetus’s heart and impairing circulation. I could see that the tumor was getting bigger, and fluid was collecting in his pericardium and lungs, which is an indication of heart failure,” he said, adding even though this had rarely been done before, the fact we have a life that may not survive otherwise makes me always want to do something.”

The procedure began similar to a Caesarean section delivery, with Dr. Cass first making an incision to expose Sam’s uterus. Using ultrasound to pinpoint the exact location of the placenta and fetus, the surgeons opened her uterus with a 12 cm incision. Then, they carefully removed enough of the fetus’s body for me to gain access to the tiny chest and heart, Dr. Najm said.

“I did ask Dr. Cass a simple question: ‘Can you actually get me access to his chest safely?’ He said, ‘Yes. I can.’ And I said, ‘I will do my part.’ That’s why it ended up being a great surgery,” observes Dr. Najm. Since fetal tissue at 26 weeks gestation is delicate and fragile, Dr. Najm had to proceed meticulously.

First, he managed to insert an IV line into the fetus’s right arm in order to deliver anesthesia, fluids and medications, if needed. Then, he carefully opened the chest through a tiny incision.

Working as expeditiously as possible, as the fetus’s heart rate was declining, Dr. Najm drained the fluid in the pericardium and removed the tumor. He saw immediate results. “All of a sudden, the heart actually got back to normal beating,” he said.

“The compression of the left atrium disappeared and there was nice blood flow.” He then inserted a temporary drain and closed the chest and skin. His task completed, Dr. Najm stepped aside and Drs. Cass and Kalan took over, reinserting the fetus fully inside the uterus and then closing the incisions in Sam’s uterus and abdomen, the statement pointed out.