If CCAMs or PSs are not causing hydrops or any other serious problems, treatment is not needed until after your baby is born. Your baby’s medical team will monitor your baby’s condition for any changes. Your baby will likely need surgery to remove the malformations.
Our board-certified pediatric anesthesiologists have extra years of training in how to give children medicine to block pain and make them sleep without pain during surgery.
After delivery, your baby will need a chest X-ray to check the malformation. If your baby is breathing and eating well and gaining weight, they will be able to go home. We will check their condition in a couple of weeks at a clinic visit.
During the first few months after birth, your baby will have a CT (computed tomography) scan to check the malformation again.
Surgery if malformations are not causing immediate problems
If your baby continues to do well, your doctor will most likely recommend surgery to remove the malformation when your baby is between 3 months and 12 months old. There is less risk with anesthesia at this age than right after birth. This still leaves plenty of time for your baby’s healthy lung to recover and grow to nearly normal size.
Even if your baby seems to have no problems now, doctors recommend removing the malformation. Both CCAM and PS malformations left in the lungs can get infected and cause pneumonia. There is also a small risk that they will become cancerous. Without removing PS malformations outside the lungs (extralobular), it may be difficult for doctors to tell them apart from cancer of the nerve cells (neuroblastoma).
Surgery if malformations are causing problems
If your baby cannot breathe and feed well after birth because of large malformations, the doctor may advise surgery soon after birth. For babies with heart or lungs that are not working well, we have an Extracorporeal Life Support Program (ECLS) for heart-lung bypass support.
Most babies have malformations in only 1 section (lobe) of their lung, so they only need 1 lobe removed (lobectomy) or only part of 1 lobe. Some babies need more than 1 lobe or, rarely, an entire lung removed. With PS malformations outside the lungs, surgeons remove the malformation but no normal lung tissue.
The surgery can be done by opening the chest (thoracotomy) or through small incisions (thoracoscopically). Your baby’s surgeon will talk with you about the risks and benefits and which option is best for your baby.