New technique replaces open-heart surgery for children

Revolutionary artificial valve replaces the need for patients with congenital heart diseases to repeatedly undergo much riskier and more expensive open-heart surgeries.

By JUDY SIEGEL-ITZKOVICH
heart 224.88 (photo credit: )
heart 224.88
(photo credit: )
For the first time in Israel, a revolutionary artificial valve was inserted into the pulmonary artery connecting the lungs and heart in a number of children in Petah Tikva this week. This procedure replaces the need for patients with congenital heart diseases to repeatedly undergo much riskier and more expensive open-heart surgeries. Only a few centers around the world have been selected to use the Melody Transcatheter Pulmonary Valve, developed and manufactured by the Medtronic company, since the first was inserted non-surgically in the US exactly a year ago. The Israeli breakthrough was performed at Schneider Children's Medical Center of Clalit Health Services, changing the lives of children suffering from severe weakness due to defective valves that leak deoxygenated blood from the heart to the lungs. The Medtronic system is inserted in the right place using a catheter topped by a supportive metal stent and pushed through a tiny incision in the skin into a blood vessel in the groin to a spot just beyond the heart, eliminating the need to open the chest, minimizing trauma and offering a speedy recovery. When the muscular wall of the heart's right ventricle contracts, the blood inside the heart chamber is put under more pressure, and the tricuspid valve closes. The valve opens when the right ventricle contracts. When the right ventricular muscles relax, blood starts back up the pulmonary trunk, causing the valve to close to prevent the flow from returning into the ventricular chamber. The pulmonary vein travels parallel to the pulmonary artery as it carries the blood back up to the heart. As children with congenital heart diseases grow up, artificial valves wear out and different sizes are needed. Until now, they have had to undergo repeated open-heart operations, risking complications such as bleeding and infections. The Medtronic valve quickly reaches the necessary location, the catheter is pulled out and the leakage stops; thus, fully oxygenated blood reaches the heart. Patients improve immediately. Congenital heart diseases occur in 0.8 percent of all newborn babies; about one-fifth of them suffer from blood-flow problems from the right ventricle of the heart to the pulmonary artery. The new valve system now makes it possible to treat very young children and eliminate the need for repeated surgery - about three or four open-heart operations even before they reach their 10th birthday. Dr. Einat Birk, head of the hospital's cardiac institute, said Schneider was chosen by Medtronic to be one of 40 centers in the world and the only one in Israel to use its Melody valve system. The catheterization with the new valve was performed by Dr. Elhanan Brookheimer (head of the catheterization unit) and Dr. Lee Benson, who came specially from the Hospital for Sick Children in Toronto. Birk and Brookheimer spent time at London's Great Ormond Street Hospital for Children to learn the technique. They said that using non-surgical means to replace open-heart surgery was "a dream" only a few years ago. "Tomorrow it will become the standard treatment." A wide variety of valve problems in children and adults will be solved by these new developments, the pair added. Medtronic (founded in Minneapolis in 1949) is the world leader in medical technology providing long-term solutions for people with chronic disease. Each year, six million patients benefit from Medtronic's technology, used to treat conditions such as diabetes, heart disease, neurological disorders and vascular illnesses.