SEP 18, 2017 12:02 PM PDT

Born with a Heart Defect: Twenty Years Later

WRITTEN BY: Kara Marker

A congenital heart defect that used to be a death sentence is now treatable thanks to an approach based on “Fontan circulation.” But as people who received this procedure as newborns grow older, researchers are seeing more instances where additional procedures are necessary to sustain the health of the heart.

A 6-month-old boy was admitted to the Camp Nathan Smith Medical Aid Clinic for complications related to a rare congenital heart defect. He is waiting to receive a life-saving cardiothoracic surgery at the Children's Hospital in Kabul.

Image credit: Spc. Breanne Pye

 

Single-ventricle disease is used to describe a variety of congenital heart defects that have one thing in common: one of the two ventricles is not functioning to its full potential. More than half of the babies that survive the three stages of procedures required to resolve single-ventricle diseases will require another heart procedure within 20 years, a new study from the Children’s Hospital of Philadelphia (CHOP) reports.

Depending on which ventricle is dysfunctional, single-ventricle disease is treated with a series of procedures designed to ultimately reach Fontan circulation: doctors empower the fully-functioning side of the heart to pick up the slack from the other side. The fully-functioning side completes the more difficult job of pumping oxygenated blood from the lungs to the rest of the body, and the blood returning from the body travels to the lungs “by direct blood vessel connections” rather than by the help of a ventricle as a pump.

The procedures begin within the first week of a baby’s life. The Fontan operation is done when the baby is between 18 months and two years old. It is the third and final stage of the repair and is done to make sure deoxygenated blood coming from the body tissues stops by the lungs before going to the heart.

"Unfortunately, for many patients, the Fontan is not the final intervention," explained study leader Andrew Glatz, MD.

While the Fontan operation gives babies with single-ventricle heart defects the best chance of living a normal life, it cannot provide normal blood circulation - it cannot make the defect obsolete. Additionally, there is a long-lasting risk of complications that are not yet fully understood by scientists.

The new study from CHOP was a retrospective review of 773 patients who had the Fontan operation at CHOP between 1992 and 2009. Researchers looked at re-intervention rates; how many babies who underwent the Fontan procedure grew up to require an additional procedure?

Results showed that 65 percent of the patients in the review had to have a re-intervention procedure within 20 years of their Fontan operation. Catheter-based procedures were the most common, mostly to “close unwanted openings or to widen narrowed blood vessels.” For those who underwent an operation, usually it was to “place or revise” a pacemaker.

“Many patients require further interventions after the Fontan to continue to try to optimize the circulation as best as possible,” Glatz explained. “It's important for families and doctors to understand this, so expectations are clear.”

The present study was published in the journal Circulation: Cardiovascular Interventions.

Sources: C.S. Mott Children’s Hospital, Cincinnati Children’s Hospital, Children’s Hospital of Philadelphia

About the Author
  • I am a scientific journalist and enthusiast, especially in the realm of biomedicine. I am passionate about conveying the truth in scientific phenomena and subsequently improving health and public awareness. Sometimes scientific research needs a translator to effectively communicate the scientific jargon present in significant findings. I plan to be that translating communicator, and I hope to decrease the spread of misrepresented scientific phenomena! Check out my science blog: ScienceKara.com.
You May Also Like
OCT 23, 2020
Clinical & Molecular DX
Follow Your Heart: A Genetic Predictor of Cardiovascular Disease
OCT 23, 2020
Follow Your Heart: A Genetic Predictor of Cardiovascular Disease
Cardiovascular disease is the leading cause of death globally, resulting in the loss of nearly 18 million lives each yea ...
NOV 14, 2020
Cardiology
Chili Peppers May Help Us Live Longer
NOV 14, 2020
Chili Peppers May Help Us Live Longer
Researchers presented preliminary data at the American Heart Association's Scientific Sessions 2020 that suggested t ...
DEC 03, 2020
Chemistry & Physics
3-D Printed, Realistic Heart Model for Training Future Physicians
DEC 03, 2020
3-D Printed, Realistic Heart Model for Training Future Physicians
Building a realistic tissue model is critical for training young physicians and surgeons, and yet challenging due to the ...
DEC 08, 2020
Cardiology
Some Stroke Risk Disparities May be Linked to Heart Structure
DEC 08, 2020
Some Stroke Risk Disparities May be Linked to Heart Structure
Scientists have found that there are structural differences in the heart's left atrium in Black and white people, an ...
DEC 11, 2020
Cell & Molecular Biology
E-Cigarette Flavors Damage Heart Cells
DEC 11, 2020
E-Cigarette Flavors Damage Heart Cells
E-cigarettes or vapes were introduced a few years ago, and researchers are still trying to learn more about how they aff ...
FEB 10, 2021
Cardiology
Finding the Link Between Air Pollution & Heart Disease
FEB 10, 2021
Finding the Link Between Air Pollution & Heart Disease
While many studies have shown that air pollution is linked to negative health impacts including poor cardiovascular heal ...
Loading Comments...