As of Friday, August 17, 2018
Few occasions are more joyous than the birth of a child. But for scores of families, the arrival of a newborn can also augur heartbreak.
Each day, nearly 100 U.S. babies are born with congenital heart defects. Many will not make it to their first birthday.
Fortunately, several breakthrough technologies have emerged in recent years that could save many of these babies. It’s time we put them to more widespread use.
Congenital heart conditions afflict about 40,000 babies -- nearly 1 percent of births -- annually. These defects can range from manageable to fatal: a valve that doesn’t fully close; abnormal connections of veins and arteries; even a hole inside the heart.
Some heart defects can be treated with medicine; others require surgery. But too often, current technologies are insufficient for infants.
Medical devices, including those for the heart, are often designed for adults. That’s where the greatest demand is. So that’s where companies tend to focus their research, development, and production efforts.
However, using adult-sized products in children can be dangerous. Forcing an adult-sized valve into a baby’s tiny heart may ward off immediate death and give the child a few more months of life.
But complications are common. For instance, an adult-sized valve can impede the flow of blood from the baby’s lungs or put pressure on the electrical circuitry of a tiny heart, resulting in the need for a pacemaker.
Attempts to treat infants with adult-sized devices may be well-intentioned, but the heart defect is likely to win out in the end.
As a cardiac surgeon, I’ve unfortunately seen that happen too often. I remember the case of an infant girl from New York City who was born with severe narrowing of her heart’s mitral valve. When she was nine months old, she received a replacement adult-sized valve.
But six months after her procedure, the replacement failed, causing her valve to narrow and restrict blood flow. Doctors relieved the obstruction temporarily. But eventually, her heart became too weak, and she passed away.
Thankfully, scientists and companies are developing new ways to meet the needs of our smallest, most vulnerable patients. Researchers at the University of Maryland, for example, are testing the ability of adult stem cells to repair damaged infant heart tissue. A team at the Mayo Clinic in Minnesota is pioneering a procedure that uses umbilical cord blood to strengthen infant heart muscles.
And just this year, Abbott, the company I work for, received approval from the Food and Drug Administration for a new heart valve for infants. At just 15 millimeters, it’s the smallest mechanical heart valve in the world.
This valve has already helped save the lives of numerous infants. One was a baby from Chicago who was born with a hole in her heart. At six months, her mitral valve started leaking following surgery to repair the hole.
She went into heart failure. She was held in the ICU but she couldn’t tolerate food and wasn’t gaining weight. She received the small Abbott valve just in time -- and is now thriving.
Today, we can fix many previously incurable heart defects thanks to a new crop of medical innovations designed specifically for our smallest patients. It’s up to the entire medical community to make sure that newborns who could benefit from these life-changing technologies receive them.
Dan Gutfinger is a medical director for the global health care company Abbott. (For U.S. Important Safety Information on the Masters HP Series, visit http://abbo.tt/2taeyVL.)