Heart surgery is dangerous as any time of time, but it’s doubly so when performed on newborns. Congenital heart disease is the most common birth defect seen in infants and every year about 1% of babies are born with under formed or malformed hearts. There are procedures to help fix the damage done by heart disease including a heart transplant. However, a heart transplant is risky for newborns and if it can be delayed, the child will have a better chance of survival.
A study done by the National Heart, Lung, and Blood Institute examined the traditional surgical procedure done to fix a severe congenital heart disease called hypoplastic left heart syndrome, which is when the left ventricle of the heart is under formed and not pumping blood to the body. The traditional method takes three surgeries spaced out through the first year to year and a half of a child’s life. After this, a heart transplant may or may not be necessary. Researcher’s wanted to see if a newer form of the surgery worked more efficiently and increased a child’s chances of not needing a heart transplant.
The traditional procedure uses a shunt called the modified Blalock-Taussig (MBT), and the newer shunt is called the right ventricle-to-pulmonary artery shunt (RVPA). The same number of surgeries is performed for both types of shunts and the surgeries are still spaced out over one to one and a half years usually starting within the first two weeks of life. The difference lies in where the shunts are placed in the heart. The first shunt, the MBT, is placed from a branch off of the aorta. The RVPA shunt is placed between the right ventricle and the pulmonary arteries.
Five hundred and forty-nine infants received shunts in multiple different sites throughout the United States. About half of the infants received the MBT shunt, while the other half received the RVPA shunt. Researchers tracked the infant’s progress through the three surgeries and found that at the end of the one to one and a half year period, the RVPA shunt seemed to work better for the first year after surgery and increased the survival rate.
The lead author of the study, Dr. Richard G. Ohye, head of the Pediatric Cardiovascular Surgery Division at the University of Michigan, said that "we found that the right ventricle-to-pulmonary artery shunt improved the chances of being alive without a heart transplant one year after surgery. However, the benefit appears to be limited to the first 12 months, as the two shunts showed similar results after about two years.”
The research team concluded at the end of the study that the new shunt did in fact increase the chances of survival for the first year, which allowed the infants time to grow strong enough to be able to receive a heart transplant if they required it.
Source: (2010, June 27). Newer heart surgery for infants offers first-year survival benefit over traditional procedure. National Institutes of Health (NIH).