Archive for the ‘Catheter’ Category

What do you see?

June 25, 2010

“Through the mirror of my mind…” – Reflections, (1967) Diana Ross and the Supremes

I have a chest full of scars (Long time Funky Heart! readers have seen them) and they don’t bother me. I see them every day in the mirror and I am comfortable with them; but it wasn’t always like that. At one time I didn’t think of them as marks of survival, but as the debris of a real life horror story. I was much too young to remember the aftermath of my first surgery, but I was ten years old when I had my second. I remember that one quite well. I remember not being able to move my left arm without pain and I remember the bloody bandage that covered the incision. In all honesty, I did have a little seepage and there was a small amount of blood. But remember that I was young and I hadn’t been out of surgery that long.

I didn’t want to see them, didn’t want others to see them….and I’m not quite sure when or how it happened, but as time passed I came to appreciate them. They all show that “I’m still here!” Now I won’t pull open my shirt for strangers (You notice that you can’t see my face in that scar photo) but I’m not ashamed of them.

Some of us, however, are never able to make peace with our scars. And they certainly aren’t lesser people because of it; you have to do what is right for you. Thanks to new surgical techniques developed at Children’s Hospital Boston, future CHDers may not have to worry about a chest full of scars.

This really wasn’t intended to reduce scars, far from it. Dr Pedro del Nido started by looking for something – anything – that would avoid placing a young child on a Heart/Lung bypass machine. Long term exposure to the bypass machine can cause damage to a child’s developing brain, and del Nido would prefer to avoid that if at all possible. The technology to make this happen didn’t exist yet, so del Nido pretty much invented it.

His ideas developed two angles, both attacking the problem: superior heart imaging and using robotics in Congenital Cardiac Surgery. The imaging was very important, as a surgeon needs a good look at what is going on inside of a damaged heart before attempting a repair. Previously the only way to see what was going on was to cut the heart open – exactly what they were trying to avoid. Also, the imaging needs to be exceptionally good. An infant’s heart is the size of a walnut, and operating on it requires precision. So your imaging equipment had better be good. It was good, but it wasn’t what the team needed. The doctor needed to see the heart, functioning, in real-time, and preferably in three dimensions. Something that good didn’t exist, so del Nido and his unit decided to make one.

OK, that’s easier said than done. But the video game industry was already doing it, so Boston Children’s got together with a graphics card maker and rebuilt an Ultrasound machine. The surgeon has to wear special glasses to create the 3-d effect, but it works!

And then there was the robotic surgery angle. Making a small incision and doing everything through a Catheter – type device would not only reduce the number of scars, but would allow a surgeon to operate on a beating heart. That in itself would be a challenge in a child’s heart, where there isn’t enough room to change your mind. So the team developed a small tool – and it is small indeed, only a millimeter – that can be inserted into a beating heart and make surgical repairs. The time of surgery is shorter and the recovery takes less time, also.

So maybe the day is coming when you can have heart surgery but not have the scarring that goes along with it.  Don’t laugh, don’t doubt, because it wasn’t that long ago that everyone seemed to have that circular scar on their arm from the Smallpox vaccine. We don’t see those around too much any more – Smallpox was beaten.

We’ll beat Heart Defects one day, too!

Invest in a Cardiac Kid’s Future

March 31, 2010

You’ve seen the TV ad in which the guy says “You can pay me now or you can pay me later!” The implication is that you can pay a reasonable amount now, to protect your car, or pay a lot more later, when the car breaks down and needs major repairs.

That’s the theory behind the push for funding for the Congenital Heart Futures Act (CHFA). As mentioned yesterday, Section 425 (C) authorized the provisions of the CHFA, but does not fund it.To put it bluntly, we need some cash.

During the Lobby Day 2009 event we looked for sponsors for the Congenital Heart Futures Act and asked for twelve million dollars annually to fund it. Let’s assume that this year, our goal is fifteen million dollars per year until the Act expires in 2015 – a total of seventy-five million dollars.

$75,000,000 – that’s a lot of money.

But consider the cost of Congenital Heart Defect care. A 1994 study estimated that the cost per CHD patient under 21 years old varied from $47,500 to $73,600. And remember, that study is 16 years old! The Utah Birth Defect Network estimated a lifetime cost of $1.2 billion dollars for Congenital Cardiac care – and they were only looking at children born with certain defects ( Tetralogy of Fallot, Transposition of the Great Arteries, Single Ventricle Defects, and Truncus Arteriosus) during the study year. And a 2008 study estimates that the costs of hospitalization for adults with Congenital Heart Defects to be 3.1 billion dollars.

So let’s fund the Congenital Heart Futures Act. Activate the National Congenital Heart Disease Surveillance System. Expand CHD research. (Don’t let anyone tell you that there isn’t any Congenital Heart Defect research going on; there is. Click HERE for a list of current Clinical Trials or HERE for the U.S. National Library of Medicine. Just type “Congenital Heart Disease” in the search box).

Funding the Act could lead to improvements in all our lives, but especially for the Cardiac Kids. If we can make surgery a little easier to deal with, replace a surgery with a Catheterization procedure, or reduce the number of medications we have to take, funding the Congenital Heart Futures Act won’t be an expenditure – it will be an investment!

$75,000,000 vs. $3,100,000,000.

You can pay me now, or you can pay me later.

New findings indicate source of A-Fib

December 29, 2009

Atrial Fibrillation, or A-fib, is one of the problems many CHDers will face. In a normal heart, an electrical signal is generated by the Sinoatrial node (also known as the SA node and is located near the top of the Right Atrium) and flows outward, causing the Atria to contract. When the electrical impulse reaches the Atrioventricular node, (AV node) it triggers its own electrical impulse which causes the Ventricles to contract, creating the “lub-dub” heartbeat we are all familiar with.

But when extra electrical impulses are moving through the heart’s electrical system, the Atria won’t contract, but rather fibrillate, or quiver. And if the electrical pulse isn’t strong enough the AV node won’t activate the Ventricles. A-fib is usually asymptomatic and painless, (though you can feel your heart beating out of rhythm) but there is a very real chance that the blood pooling in the not-quite-beating upper chambers can clot and cause a stroke.They can also lead to Congestive Heart Failure. (CHF)

One of the usual techniques used to stop A-fib is ablation. Before an ablation, the heart is examined closely and “mapped” to determine where the extra electrical impulses are coming from. Then a catheter is inserted through a vein in the leg or the neck and is guided to the heart. The sources of the extra electrical impulses are then “zapped” (or frozen) to knock them out, and the heart beat should be restored to normal. It doesn’t always work.

But researchers have recently determined that the cells that produce the heart’s electrical charge – and can cause Atrial Fibrillation – also express the protein DCT. DCT only originates from a couple of sources in the body, and only one inside the heart – the electrical current cells. So if scientists can learn a way to identify DCT cells in the heart, they’ll have a way to determine where electrical pulses can orgininate – and deaden the ones causing A-fib.

But this technology is a long way from being reality, if it works at all. Right now, studies are being conducted on mouse hearts. Mouse hearts are similar to human hearts, close enough to be used in research. But when it comes to transferring the results from a mouse to a man, there is a lot of difference!