Approximately 9 of every 1,000 people are born with some form of heart defect, the most common of which are septal defects, or holes in the walls within the heart that divide it into chambers. Some of these defects close spontaneously as a child grows up but others require medical intervention.
For the last few decades, open-heart surgery was required to repair septal defects. This surgery requires opening the chest cavity, breaking ribs, a heart-lung bypass machine, and ventilator followed by almost a week in a pediatric intensive care unit (PICU) and a long recovery at home. Many stitches are needed to close the surgical site so the patient is left with a massive scar running down the middle of the chest. Infection is always a concern until the surgical site closes completely and the scar remains visible for life.
Dr. Makram Ebeid is perfecting an easier fix. He uses a wire catheter inserted through a tiny cut in the patient’s thigh. Non-invasive X-ray imaging provides guidance while the doctor maneuvers the catheter up through a vein or artery to the patient’s heart. Once there, a plug is placed in the hole and the catheter is removed. A Band-Aid closes the insertion site and the patient spends the night in a regular pediatric room. Most kids are ready for active play before they’re even released from the hospital and parents see immediate improvements in their children’s energy levels.
Ebeid is a professor of pediatric cardiology at the University of Mississippi Medical Center (UMMC) and director of its Pediatric Catheterization Lab. His work with catheterization for heart defects is part of a clinical study to test a plug made of nickel and platinum manufactured by St. Jude Medical, Inc., headquartered in St. Paul, Minnesota.
Ebeid is gaining a reputation for closing ventricular septal defects using catheterization rather than open-heart surgery for even the most complex cases. Doctors at other medical institutions around the country refer patients to him when they don’t feel comfortable enough themselves to perform the procedure.
The approach Ebeid takes with parents of a sick baby is one of full disclosure. He fully explains both procedures — surgical and catheterization — so the parents can make an informed decision as to which method they prefer for their child. Ebeid also makes sure parents understand surgery has been the standard treatment for holes in the heart for 40 years and that catheterization is still new and relatively untested.
If, however, Ebeid feels surgery is the best option for a particular child, he transfers care to his colleague, Dr. Jorge Salazar, a professor of pediatric heart surgery and co-director of the Children’s Heart Center at UMMC. Salazar is at the ready during Ebeid’s catheterizations, too, in case catheterization reveals a need for surgery rather than catheterization.
Of Ebeid’s work, Salazar says, “If we can achieve the exact same result using a catheter that goes up the leg, then why wouldn’t we do it? I have seven children. If one had a hole in his heart, I would choose the catheter.”
Source: “New procedure at UMMC repairs heart without opening children’s chests.” The University of Mississippi Medical Center. University of Mississippi Medical Center. May 6, 2014. Web. May 19, 2014.