Doctors believe they have made a breakthrough in treating potentially fatal heart conditions in babies while they are still in the womb.
The leader of a London surgical team yesterday described how members had operated on two boys and a girl months before they were born in an attempt to improve their long-term chances after birth. One infant is now aged 18 months, the second three months old, and the third a month old.
Helena Gardiner, from the Centre of Foetal Care at St Charlotte's and Chelsea hospital, London, suggested their expertise could help one or two babies a week in Britain once the techniques were fully developed and available in other hospitals.
The microsurgery, on foetuses with valve diseases, involved entering the unborn babies' hearts via their mothers' abdomens, uterine walls, and the foetuses' chests. The operations, under local anaesthetics for the mothers and pain relief for the foetuses, should enable mothers to carry babies for their full term, avoid the complications associated with early deliveries, and give the babies' hearts an extra chance of developing normally.
In the cases of the first boy and the girl, the team, including members from the Royal Brompton hospital, London, managed to widen "sticky" or underdeveloped valves which prevented blood flowing normally from the right ventricle of the heart into the pulmonary artery. In the other, doctors operated on a aortic valve.
They inserted little balloons into the hearts before inflating them, a technique used in treating adults with circulation problems.
The first case, of the boy now I8 months old, is reported in the Lancet today, along with an account of a similar operation performed in Linz, Austria. But Dr Gardiner, who led the British team, said there had been two further successes.
The technique had been tried before, mainly on the aortic valve, but only one of 14 cases reported worldwide was seen as a long-term success.
The 18-month-old boy was the first unborn child in Britain in whom balloons had opened the pulmonary valve. He was operated on 28 weeks into his mother's pregnancy.
The other boy had his aortic valve treated at 23 weeks, while the girl was operated on twice in the womb, at 24 and 29 weeks.
Dr Gardiner said the babies were "doing fine so far", although all had needed further operations after birth: "When these operations are performed the heart is about the size of a large grape, so it is a very difficult procedure. With more experience, better equipment and a growing understanding of the foetus, this technique could be developed to help other unborn babies in danger of heart failure."
· Sir Ian Kennedy, 61, is to head the commission for healthcare audit and inspection, the new body to oversee the health service.
