(c) Norbert von der Groeben
生後間もなくペースメーカーが埋め込まれたJayaちゃんと両親
生後間もない未熟児に，心臓ペースメーカーを埋め込む手術が成功した。この赤ちゃんは，胎児の時に心ブロックという重篤な心臓欠陥が見つかった。この欠陥のある胎児は出生前や生後数週間で亡くなる危険性が高い。そこで，帝王切開で早期に出産後，すぐにペースメーカーを付けることが計画された。当初，数週間後に再手術を要する体外式機器を取り付ける予定だったが，外科医が手術中に，赤ちゃんの状態を見て体内への埋め込みを決断した。経過は良好で，今後は数年ごとのリードの調整や電池の交換以外は正常な生活が送れる見込みだという。（吉田素子）
Packard Children’s Has Smallest Child Yet to Get Pacemaker
Jaya Maharaj was 15 minutes old when she was sent to surgery at Lucile Packard Children’s Hospital and given a pacemaker that saved her life. The tiny girl -- born nine weeks early, weighing 3.5 pounds, with a heart slightly bigger than a walnut -- had been diagnosed before birth with a severe heart defect. She is smaller than any pacemaker recipient ever reported in the medical literature.
Jaya’s surgery is remarkable not just because of her small size but because many fetuses with her condition, congenital heart block, do not survive pregnancy. Research has shown that 20 to 50 percent of patients diagnosed prenatally die in utero or in the first weeks after birth. Yet premature delivery to implant a pacemaker carries its own hazards. When Leanne Maharaj, Jaya’s mom, was first referred to Packard Children’s from her hometown of Hayward, Calif., at 28 weeks pregnant, her doctors weighed the conflicting risks.
“We knew that at any time the baby’s heart could give out,” said neonatologist Valerie Chock, MD, a member of the large, multidisciplinary team that planned Jaya’s birth and surgery. “We had to decide: At what point do we deliver to balance that risk against the risk of premature delivery?”
Congenital heart block develops if, during pregnancy, the mother’s immune system mistakenly attacks nerve fibers that transmit heartbeat signals through the fetal heart muscle. When this happens, the fetal heart rate becomes dangerously slow.
［単語和訳］
Pacemaker：心臓ペースメーカー
surgery：手術 walnut：クルミ had been diagnosed with：～と診断されていた heart defect：心臓欠陥 recipient：レシピエント（この場合，ペースメーカーを埋め込まれた人）
fetuses：胎児 congenital heart block：先天性心ブロック pregnancy：妊娠期間 prenatally：出生前に in utero：子宮内で premature delivery：早産 implant：～を埋め込む carries hazards：危険を伴う was referred to：～に紹介された ～weeks pregnant：妊娠第～週である conflicting：相反する
give out：だめになる neonatologist：新生児科医 MD：医師 multidisciplinary：学際的 deliver：分娩させる
immune system：免疫系 nerve fibers：神経線維 transmit：～を伝達する heartbeat：心拍の fetal：胎児の heart muscle：心筋 heart rate：心拍（数） dangerously：危険なほど
