Using a piece of Gore-Tex fabric to make their repairs, doctors performed corrective surgery on a baby born with his heart outside his chest, and said Wednesday that the youngster should be able to lead a close-to-normal life.
Naseem Hasni underwent surgery to put his heart inside his chest hours after being delivered by Caesarean section Oct. 31 at Holtz Children's Hospital.
He remained in critical but stable condition Wednesday.
"He's not going to be able to play certain kinds of sports where a blow to the sternum to you and me wouldn't be a problem, but in him it would be. So I think some competitive sports are going to be out," said Dr. Eliot Rosenkranz, a cardiothoracic surgeon, "but he's going to be able to participate in other sorts of activities."
He added: "Certainly the goal is as normal a childhood as he can achieve."
Before the surgery, Naseem's heart looked like a peeled plum sitting atop his pink chest, with the aorta diving back underneath the skin. Nevertheless, the heart was beating away normally.
During the six-hour operation, surgeons first wrapped Naseem's heart in Gore-Tex, then a layer of his own skin, to substitute for his missing pericardium, the sac that encloses the heart. The heart was then slowly eased inside his chest.
The baby was born with an extremely rare congenital defect, ectopia cordis, in which the heart grows outside the body and the chest wall and sternum fail to develop. The defect was spotted in an ultrasound exam in late September after the mother, Michelle Hasni, 33, began feeling unusual movement from the baby.
"He was having hiccups, but it was constantly and it was every day. I wasn't sure what the movement was," the Miami woman said.
Naseem was delivered at 36 weeks, a few days early. Surgeons made a larger incision than normal to ensure that the heart would not be squeezed or touch any part of the womb. Other than the heart defect, Naseem had developed normally: He was 21 inches long and weighed 9 pounds, 2 ounces at birth.
In a few weeks, Naseem will be fitted with a protective piece of plastic to wear over his chest. When he is about 6 months old, surgeons will graft pieces of his own ribs across his chest to create a sternum, or breastbone.
While doctors had not initially been sure that Naseem would survive until Thanksgiving, he could be home with his family as early as Christmas, Rosenkranz said.
Ectopia cordis occurs 5.5 to 7.9 times per 1 million live births, and the survival rate after surgery is less than 50 percent, the boy's doctors said.