A medical procedure now available in South Carolina lowers the chance of infection and speeds recovery time compared with traditional treatment for patients with congenital heart disease.
Patients who have had heart disease since birth typically require multiple open-heart surgeries over their lifetimes to fix valves that don't pump blood as efficiently as they should, doctors said. Such operations, which carry a risk of infection and require surgeons to break the breastbone, generally require two months recovery and up to a week in the hospital.
The new procedure, performed at the Medical University of South Carolina for the first time earlier this year, instead allows doctors to repair heart valves through a catheter inserted through a vein in the patient's groin. It typically requires only an overnight hospital stay and allows patients to return to their normal lifestyles within a week, said Hamilton Baker and Varsha Bandisode, cardiac specialists who perform the new treatment, and J. Philip Saul, chief of pediatric cardiology at MUSC Children's Hospital. MUSC doctors have performed the new procedure on about a dozen patients since January and expect to do three or four a month.
Congenital heart disease, in which babies are born with narrowed or missing heart valves, is the most common birth defect, affecting eight in 1,000 babies annually, Saul said. Within the first few months of life, babies with the disease usually require open-heart surgery for doctors to implant artificial valves to make blood flow properly, he said.
As a child grows, though, the tube containing the artificial valve can narrow, constricting blood flow, Bandisode said. Over time, the tube wears down and must be replaced, which could happen every few years, she said.
The new procedure, called transcatheter pulmonary valve therapy, now can be used instead of open-heart operations to repair or replace worn-down tubes, Saul said. Studies in Europe show the device inserted through the procedure can last longer than 10 years, he said.
Open heart surgery still will be necessary for the original implantation of the tube containing the artificial valve and for the placement of an adult-sized tube once a child reaches adulthood, Saul said.
Laurie Fladd was the first patient at MUSC to undergo the new procedure. The 42-year-old Summerville resident had three open-heart surgeries when she was a child. Late last year, her doctors said the tube containing her artificial valve was narrowing, causing her heart to work too hard.
"I didn't want any more open-heart surgeries," Fladd said. "It's not an easy thing to go through. I remember being in the hospital about 10 days -- and that was considered short."
She was back at home the day after the January procedure and said she had only minor soreness.
"I woke up thinking, 'Did they really replace it?'<2009>"
Christine Goulette, a 13-year-old from Florence, had the procedure in May. Although she will need at least one more open-heart surgery to implant an adult-sized tube noninvasive procedure fixed her valve and "buys her time" until she's fully grown and the bigger tube can be implanted, Christine's mother, Kim Goulette, said.