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Early Detection of Rare Tumor Helps a Little Heart

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Baby Arley Rey Valenzuela has loving parents, a big sister who dotes on her and a dog who’s always ready to play. It’s hard to imagine she might not be part of this loving family without the joint efforts of medical professionals in two cities across 600 miles.

Brailey Valenzuela with baby Arley and big sister
Brailey Valenzuela with her daughters

Those efforts began at Covenant Health’s Fort Sanders Perinatal Center in Knoxville, Tennessee. The Center provides comprehensive care for high-risk pregnancies.

“She truly is a miracle,” says her mother, Brailey Valenzuela. “Arley gives us pure joy. She has the sweetest smile and loves ‘chatting’ to anyone who will listen. She does have quite the story to tell.”

Pericardial Teratoma – A Critical Diagnosis

While still tucked away in her mother’s womb, Arley developed a pericardial teratoma. The rare tumor is located in the sac (pericardium) surrounding the heart. The tumor was diagnosed during an ultrasound at Valenzuela’s 24th week of pregnancy.

“I was told a mass that was very concerning was seen around her heart,” Valenzuela says. “I was in shock. All previous ultrasounds were been normal.”

Steven Andrade, MD, says that despite its non-cancerous nature, the pericardial teratoma carried significant risks because of its placement on the sac that encased the baby’s tiny heart. Already a threat, the tumor was rapidly growing.

“Because of the location and how [pericardial teratomas] compress the heart, there generally is a moderate degree of blood flow obstruction within the heart,” Dr. Andrade says. “This can lead to fluid building up in the baby in places that it shouldn’t. It can also lead to fetal death if not removed.”

Fort Sanders Perinatal Center Team Leads Race Against Time

Understanding the urgency, the team at Fort Sanders Perinatal Center acted quickly. The following Monday, another ultrasound confirmed the tumor. The Perinatal Center made a same-day appointment with a pediatric cardiologist at East Tennessee Children’s Hospital for more advanced imaging. The cardiologist coordinated with specialists at Children’s Hospital of Philadelphia (CHOP) in Pennsylvania.

“We flew to Pennsylvania on Thursday and had extensive testing and imaging on Friday. Then we sat down with the fetal care team to further discuss the diagnosis and treatment,” Valenzuela says.

The team at CHOP determined that Arley’s heart function was rapidly declining and immediate surgery was necessary. There were risks, but Valenzuela and her husband decided to proceed, knowing it was their baby’s best chance for survival.

“She underwent an open fetal surgical resection of the tumor,” Dr. Andrade explains. “Then they closed up the fetal chest, put the baby back inside the uterus and finally closed the uterus.”

Successful Surgery Normalizes Baby’s Heart Function

Baby Arley, whose heart tumor was diagnosed at Fort Sanders Perinatal Center
Arley Valenzuela is a healthy baby after treatment for her heart tumor was initiated by Fort Sanders Perinatal Center.

The surgery was a success. After the procedure to address the pericardial teratoma, Arley’s cardiac function normalized and the extra fluid around the heart disappeared. Valenzuela remained in Pennsylvania for the remainder of her pregnancy, undergoing constant monitoring and weekly check-ups to ensure no complications arose.

The wait was long and lonely; Valenzuela missed her family and home. But the wait was worth bringing a new member of the family into the world safe and sound. She delivered her baby via C-section at 35 weeks. Today, Arley is healthy and doing well.

Fort Sanders Perinatal Center’s expertise and swift response is an example of the specialized prenatal care provided to women from all walks of life every day. The Center partners with East Tennessee Children’s Hospital to offer complete care for babies in special circumstances or emergency cases.

“We will be forever grateful to the Fort Sanders Perinatal team,” Valenzuela says. “Their ability to detect the issue, their diligence in getting us connected to East Tennessee Children’s Hospital and their timely assistance with sending necessary records to CHOP physicians was literally the difference between life and death for our daughter.”

High-risk pregnancy care is available at Fort Sanders Perinatal Center’s four office locations: downtown Knoxville, West Knoxville, Sevierville and Morristown. For more information or to schedule an appointment, visit the Fort Sanders Perinatal Center website.

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About the Author

Covenant Health

Headquartered in Knoxville, Tennessee, Covenant Health is a not-for-profit, community-owned, healthcare enterprise committed to providing the right care at the right time and place. Covenant Health is the area’s largest employer and has more than 11,000 compassionate caregivers, expert clinicians, and dedicated employees and volunteers.