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| Vol.22, No.5 |
| March 15, 2000 |
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Repairing Tiny Hearts Requires Specialized Team Approach Improvements in technology and instrumentation are among the reasons why doctors at Texas Children's Hospital say they are able to perform congenital heart surgeries on very young patients. A committed team of skilled health care professionals is also a part of the equation for success.
"Cardiac care for children is a highly specialized field," said Dr. J. Timothy Bricker, chief of cardiology at Texas Children's Hospital. "Patients receive all-encompassing care from the Heart Center staff, as well as from appropriate departments of Texas Children's." A living example is Sophia Suffredini of Austin, Texas, a 1-month-old infant who underwent an arterial switch procedure when she was only 4 days old. Sophia was born with what is called transposition of the great arteries, a condition in which the two great arteries - the aorta and the pulmonary artery - are reversed from their normal positions. In a normally functioning heart, the aorta connects to the left ventricle while the pulmonary artery arises from the right ventricle. The aorta is responsible for carrying well-oxygenated blood (red in color) in the left ventricle to the rest of the body. The pulmonary artery functions by sending the poorly oxygenated blood (blue in color) in the right ventricle to the lungs. When the connections are reversed, the aorta is then the vehicle for the poorly oxygenated blood, sending it to the body, while the well-oxygenated red blood is going to the lungs via the pulmonary artery. The effect of poorly oxygenated blood circulating in the body can be seen in the baby's skin color, which may take on a bluish hue. This is one cause of what is termed "blue baby." The surgery required in such a case involves moving the great arteries back to their correct positions. Dr. Bricker, also professor of pediatrics and cardiology at Baylor, said that the surgical approach to this congenital heart condition has improved through the years. He also said that subsequent surgeries are not expected for little Sophia. "We are constantly refining our surgical techniques," said Dr. Charles D. Fraser Jr., chief of congenital heart surgery at Texas Children's. "Because we've learned that premature children tolerate major heart operations, we now completely repair hearts in small babies. "In some cases, it is better to perform the surgeries as early as possible, rather than allowing secondary problems to develop from the heart condition," added Dr. Fraser, who also is associate professor of surgery and pediatrics at Baylor College of Medicine. In addition to the surgeons and nurses, a team of pediatric anesthesiologists and perfusionists plays a vital role in the success of each surgery. Among other duties, perfusionists operate the heart-lung machine that acts as an artificial heart and set of lungs. "Standard anesthesia techniques used for normal children can be dangerous for children with heart disease," Dr. Fraser said. "Our perfusionists customize the perfusion to each child's unique needs." John Suffredini, Sophia's father, said it was traumatic to learn his newborn daughter had a heart problem. "She is doing fantastic now," said Suffredini, looking at the baby in his wife's arms. "Doctors tell us she should have a normal childhood." In 1999, 98 percent of pediatric patients who underwent congenital heart surgery at Texas Children's Heart Center survived. This statistic reflects a 2 percent surgical mortality rate within 30 days of surgery. Eight of every 1,000 babies are born with congenital heart defects, the most common type of birth defect. Last year, Texas Children's Heart Center performed 620 surgeries, a 33 percent increase over the previous year. The Heart Center maintains near-perfect survival rates, even as the volume of cases continues to increase significantly.
- KRISTINA VAN ARSDEL,
©2006 Texas Medical Center E-Mail: tmcinfo@texmedctr.tmc.edu URL: http://www.tmc.edu/tmcnews/03_15_00/page_05.html |
