Using Advanced Technologies to Rebuild Young Hearts
Oak Lawn, Ill. – Ever searching for new approaches and technology in treating children with congenital heart disorders, Advocate Children’s Hospital is participating in two national studies, one designed to help children with artificial pulmonary heart valves avoid open heart surgery and the other intended to improve the closure of a hole between the two upper chambers of the heart.
“While the need to replace the pulmonary heart valve early in life is relatively rare, atrial septal defects (which are abnormal holes in the wall, or septum, dividing the heart’s two upper chambers) are among the most common congenital heart defects. Eight in 1,000 children are born with a birth defect of the heart – and up to 10 percent of these children have an atrial septal defect,” said Alexander Javois MD, a pediatric interventional cardiologist at Advocate Children’s Hospital—Oak Lawn.
An atrial septal defect allows oxygen-rich blood from the upper left chamber of the heart to flow into the upper right chamber and mix with blood that has come from the body and has had most of its oxygen removed. If not corrected, the defect can lead to heart rhythm problems, heart enlargement, heart failure, pulmonary hypertension and other serious disorders.
Advocate Children’s Hospital—Oak Lawn is the only Chicago area site involved in this multicenter study in which physicians are using an advanced version of a device called a Gore®Helex® Septal Occluder to permanently fill the hole in the heart wall. Delivered to the heart by a catheter that the cardiologist threads through the child’s veins, the device consists of a synthetic patch supported by a wire frame. When deployed into the heart, the device bridges and closes off the atrial septal defect to stop the shunting of blood between the heart chambers. During a period of several months, cells in the heart begin to grow over the patch, permanently sealing the hole.
“Patients are generally older than three years of age when we perform the procedure, which typically takes less than two hours,” Dr. Javois said. He anticipates that Advocate Children’s Hospital will implant 10 of the devices as part of the multicenter study.
In other work, Dr. Javois and colleagues are helping children and adults born with a defective pulmonary valve avoid multiple open heart surgeries by deploying an artificial heart valve, called a Medtronic Melody® Transcatheter Pulmonary Valve, in a minimally invasive procedure. The valve, like the Gore®Helex® Septal Occluder, is delivered by a catheter, which is inserted into a vein in the patient’s leg and then guided through the venous system to the patient’s heart. The artificial valve is attached to a wire frame called a “stent” and is opened and locked into place between the heart and lungs with the help of a balloon.
“The procedure helps us buy time for the patient. They will eventually need open heart surgery for a new valve, but this transcatheter pulmonary valve means they do not have to go through open heart surgery every time the valve needs replacement,” Dr. Javois said. “’Buying time’ for younger patients is particularly important, since an artificial pulmonary valve has to be replaced every few years as the child grows and develops.
Although the FDA has approved the valve on a humanitarian use basis (meaning it is used for rare conditions), physicians report outcome data on the device to evaluate its ongoing effectiveness and safety.
Dr. Javois and his team also have used this device in a few cases involving patients with venous systems too small to accept a traditional catheter. They have performed a hybrid surgery in which the patient’s chest is opened, and the new artificial pulmonary valve is positioned while the heart continues to beat. “With hybrid surgery, we do not have to stop the heart and put the patient on a heart-lung bypass machine,” Dr. Javois said.
As a result of the ongoing commitment of Advocate Children’s Hospital to research that will advance and improve children’s health, children being treated at this hospital have access to important and cutting-edge devices and therapies.
# # #
About Advocate Children’s Hospital As part of Advocate Health Care, Advocate Children’s Hospital is the largest network provider of pediatric services in Illinois and among the top 10 in the nation. The two main campuses are located in the Chicago metropolitan region – Oak Lawn in the southwest and Park Ridge in the northwest, with additional services accessible at other Advocate hospitals throughout the state. Advocate Children’s Hospital serves as a major referral center for infants and children. Through a special, wholistic approach, Advocate Children’s Hospital combines some of the country’s most respected medical talent with exceptional and compassionate care. In fact, the children’s hospital has been recognized by U.S. News & World Report as one of the nation’s leaders in pediatric cardiology and neonatology, and numerous physicians have been cited as being among the “Top Doctors” regionally and nationally in their respective fields. Advocate Children’s Hospital is staffed by more than 400 pediatricians and 230 pediatric subspecialists who offer a wide range of services for children.