Contact: Ryan Davenport, Fairview, 612.672.4164
MINNEAPOLIS (December 5, 2007) -- The University of Minnesota Children's Hospital, Fairview is combining the best of open heart surgery with less invasive interventional cardiology—giving babies with tiny, sick hearts the best care available.
The hospital is the only one in the state that can accommodate a cardiac surgical team and an interventional cardiology team in the same room, working side-by-side to repair a child’s congenital heart defect. These so-called hybrid procedures are performed in a specially-designed pediatric catheterization lab.
The hybrid room means patients can undergo procedures like stent placements as well as more invasive open surgeries in one room, without having to be transported from one area of the hospital to another, or having to schedule procedures separately, requiring extra trips to the hospital.
More and more heart repairs are being performed through less invasive catheterization techniques, and in the hybrid room a surgical resolution is available if necessary. Families can be assured that the heart repair will be completed, either through less invasive techniques, through traditional open heart surgery or through a combination of both.
“This is a huge innovation for the region, said Dan Gruenstein, M.D., pediatric interventional cardiologist at the University of Minnesota Children’s Hospital. “This initiative required incredible planning and clinical input, and we’re proud to be the only program to offer this to kids in the Upper Midwest.”
About eight interventional cardiology cases are performed in the new lab each week. Hybrid cases (involving a surgical component) are less common, although Gruenstein expects those numbers to increase dramatically over the next few years. There are several types of heart repairs that can be done in the new hybrid room, including Atrial Septal Defects (ASD) and Ventricular Septal Defects (VSD)—in which the baby has a hole in either an upper or lower chamber of the heart. Hypoplastic left heart syndrome—a life-threatening condition in which babies are born with essentially half of a functioning heart, can also be treated.
Historically, treatment for hypoplastic left heart syndrome required a highly complex surgery when the child is only a few days old. The baby's chest would be opened and the heart would be stopped. The baby would be put on a heart bypass machine. Also, the surgery requires a period of time when all blood circulation is halted in order to do the required repairs. During this period, blood flow to the brain is interrupted, increasing risks of neurological damage. Such a major surgery can also interfere with a newborn’s normal development. Two additional surgeries are required later.
With the hybrid room, phase one treatment is typically done in the baby's first days of life and involves an open chest surgery, but also less invasive catheterization and stent placement. However, the heart is never stopped, no bypass machine is required, and blood circulation is not interrupted to the brain or the rest of the body.
“The hybrid procedure makes a disease that was very high-risk significantly less traumatic to the developing brain,” said Gruenstein. A second procedure, involving further surgical correction, can be delayed until the child is approximately five or six months of age. A third and final procedure is also required.
Although most VSD’s are corrected in the operating room using a heart bypass machine, an increasing number can be performed in the new hybrid room. An interventional cardiologist, working with a surgical team, uses a catheter to thread a special patch through the beating heart to close the hole—no heart bypass required. If the hole cannot be properly patched using catheterization, the surgery team can step in and perform the repair using a traditional open heart surgery.
Similarly, more technically-complex ASD's can be attempted by interventional cardiology in the hybrid room using less invasive catheterization patching techniques, with surgery standing by if necessary.
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