Posts Tagged ‘Boston Children’s Hospital’

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!

Cut ’em off at the pass!

May 30, 2010

It’s a common scene in old Western movies: The good guys are in hot pursuit, but the bank robbers are getting away. “Quick, let’s cut ’em off at the pass!” someone shouts, and all the good guys gallop off through a shortcut. A few moments later, they’ve managed to get ahead of the evildoers!

For ten years now, Children’s Hospital of Boston has been working on cutting Hypoplastic Left Heart Syndrome (HLHS) off at the pass – by doing heart surgery while the baby is still in the mother’s womb! One of the early signs of HLHS is Fetal Aortic Stenosis; a small Aorta present before birth. (This can be detected through a Fetal Echocardiogram.) Boston Children’s has developed a procedure in which a probe is inserted into the mother and passes through the womb, into the unborn child, and enlarges the Aortic Valve. This is known as Fetal Aortic Valve Dilation.

An article in the June 2010 issue of Congenital Cardiology Today details the procedure and reports on an analysis of 70 attempts to repair the defect. 52 of the procedures (70%) were “technically successful.” If the Left Ventricle is small (and it almost always is) when the operation is done, the Ventricle will not grow. However, it will support growth of other Left Ventricle structures and HLHS can usually be avoided. Aortic regurgitation (backward blood flow through the Aortic Valve) happened in about 40% of the cases. And unfortunately, death occurred 13% of the time.

But the good news is we are starting to be able to fight a severe Congenital Heart Defect before the child is even born – and stopping a severe Congenital Heart Defect almost before it starts!