From a single tubular structure present at around the fourth week of pregnancy, humans develop a complex, four-chambered heart that keeps blood moving through the cardiac chambers, lungs, and body over a lifetime. The heart’s development can be altered by a number of genetic and environmental factors during the early stages of fetal growth, causing a range of structural abnormalities that, in general, are termed congenital heart defects (CHD).
These are the most common birth defects in the United States, affecting eight in 1,000 newborns. CUMC, site of the world’s first successful pediatric heart transplant in 1984, remains a leader in research and treatment for CHD, and the Division of Pediatric Cardiology is continuing to expand under its recently appointed Division Chief Julie Vincent, MD.
“These devices have gotten much smaller, allowing their use in very small infants and children,” Dr. Vincent says.
Dr. Vincent is an interventional cardiologist who treats pediatric and adult CHD with minimally invasive procedures. She joined CUMC to head the Pediatric Cardiac Catheterization Laboratory in 2008 and was named Division Chief late last year. The division has added three new faculty members in the past year and is in the process of recruiting two additional subspecialists, making a team of more than 30 faculty members. The division’s growth parallels the availability of new technologies and innovative, less invasive procedures that make it possible to correct heart defects in more patients born with CHD.
This year, CUMC is celebrating a milestone: the 30th anniversary of its pediatric heart transplantation program. The program has been under the direction of Linda Addonizio, MD, for pediatric cardiomyopathy, heart failure, and transplantation, since its inception. Transplant medicine has evolved with the recent advent of very small ventricular assist devices and mechanical heart pumps that can move blood through failing hearts in infants and small children, says Dr. Vincent. These devices benefit children with severe heart failure who are waiting for a donor heart (heart transplantation). Such devices may also act as a bridge to recovery for children who have developed a severe immune reaction to their transplanted heart (called rejection) or for children with acute inflammation of their heart (myocarditis), she adds. “These devices have gotten much smaller, allowing their use in very small infants and children. Further, advances in these devices have significantly decreased the incidence of complications, such as clotting in the tubing and subsequent stroke,” Dr. Vincent says.
Read the full article on page 9 in the fall edition of Connections.