Las Vegas Plastic Surgery
Heart Beating Outside A Baby’s Chest Repaired by Cardiothoracic and Plastic Surgeons
A recent report out of Texas documents the birth of a baby with Ectopia Cordis, which is Latin for “outside heart.” It is a rare congenital abnormality seen in 1 in 100,000 births in developed countries, in which the heart is abnormally located either partially or totally outside the thorax. The ectopic heart can be found along a spectrum of anatomical locations, including the neck, chest or abdomen. In most cases, the heart protrudes outside the chest through a split sternum. The heart is unprotected by the pericardium, sternum or skin. Other organs may also form outside the skin. Many cases of ectopia cordis have other congenital heart defects associated with them. The usual prognosis for ectopia cordis is poor. Successful surgeries have been performed, but the mortality rate remains high.
While many think that Plastic Surgery is all about aesthetics, plastic surgeons go through rigorous training in reconstructive surgery as well. Together, the Cardiothoracic and Plastic Surgery teams at Texas Children’s Hospital were able to place the baby’s heart back to where it belonged, and cover the heart with soft tissue. Each team has a role in the process. The Cardiothoracic team treats the congenital heart abnormalities and the Plastic Surgery team devises a more sturdy protective construct to shield the heart. One of the best approaches plastic surgeons can utilize is to take methyl methacrylate, bone cement, and make struts to go over the heart. Then one must place soft tissue, pectoralis major muscle, on top. This can make a very sturdy construct.
While a Faculty/Fellow at Los Angeles County/ U.S.C. I was privileged to be involved in a case of a boy who underwent just this operation. He came in to the clinic in Santa Monica out of the blue at age 10, (ten years after his surgery). He described no issues. He was able to run and play. He stated that on multiple occasions, he was hit by the soccer ball in the chest without any problems. Sometimes in medicine and surgery, you get the privilege to make a difference and knowing that this boy is a happy, healthy ten year old is certainly something to be treasured.
We wish the young Texas patient and her family the best of wishes for a speedy and uneventful recovery. We hope that the excellent teams led by Dr. Charles Fraser (Surgeon in Chief) at Texas Children’s Hospital will continue to update us as to the progress of the little girl, whose heart now is “truly in the right place”…
Jeffrey J. Roth, M.D., F.A.C.S.