Pediatric Heart Programs & Services
We offer our young patients state-of-the-art care for all pediatric heart conditions, with top-quality outcomes for even the most complex of cases. Some of our program highlights include:
Prenatal Cardiac Diagnosis And Intervention
For some children, taking care of their hearts must begin even before they are born. The Congenital Heart Center has one of the largest and most experienced maternal-fetal medicine teams in the country our Center for Prenatal Pediatrics is the only one of its kind in the New York area, offering comprehensive prenatal diagnosis and therapy.
Hybrid Heart Surgery
The Congenital Heart Center is one of just a few centers in the U.S., and the only one in the tri-state area, offering hybrid cardiac surgery for infants and children. Hybrid heart surgery combines conventional surgical methods with minimally invasive, catheter-based interventional approaches to permit much smaller incisions, avoid the use of a heart-lung bypass machine, and promote a faster recovery. Our center evaluates all patients for less invasive treatment options, which may also allow our surgeons to treat a condition with a single operation rather than a series of procedures. Our interventional cardiologists offer percutaneous procedures, a less invasive option for valve repair and replacement, using a catheter inserted through a small incision in the groin.
A One of a Kind Pediatric Heart Valve Center
Leadership in Heart Transplantation
How Often Is Sts Data Updated
Childrens Colorado and other centers submit data to the STS twice per year. The STS then verifies the data and generates reports that allow us to compare our results with our peers.
We publish our outcomes data on this website as soon as possible following the STS data release, also twice per year.
Why Would A Newborn Require Heart Surgery
Heart abnormalities present at birth are called congenital heart defects .
CHD can lead to problems with any part of the heart, including the upper and lower heart chambers, the atrial and ventricular septae, the large and smaller blood vessels and the heart valves.
Genetic conditions can also be associated with CHD.
Heart surgery might be needed in the neonatal period for critical congenital heart disease. This means that without repair, the infant will not survive.
Procedures could include:
Treatment process
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Handling Your Baby After Surgery
To ensure your that babys wound heals evenly, it is important not to pick them up under their arms for a period of 6 weeks. The nursing staff will teach you how to pick you baby up using the scoop technique. When you go home it is important that you teach anyone who might pick up you baby how to do so correctly.
What Are The Most Common Types Of Congenital Heart Disease
While there are many kinds of congenital heart defects, the most common ones affect the walls inside of the heart, the valves, or the large vessels that carry blood from the heart. Some of these defects will never need to be treated, while others may involve multiple structural problems and require surgery soon after a baby is born.
Examples of common congenital heart defects include:
Atrial septal defect : A hole in the wall between the two top chambers of the heart is normal at birth, but it should close after birth. If it doesnt close, it can cause abnormal blood flow inside the heart. Children with an ASD have few symptoms. Depending on the size of the hole, using a catheter-based technique or open-heart surgery to close it can often prevent serious problems later in life.
Ventricular septal defect : The wall that separates the two lower pumping chambers of the heart is normally intact. However, if a hole or VSD is present, higher pressure from the left ventricle can cause the blood to flow into the right ventricle. The latter can cause extra blood to be pumped into the lungs and create congestion in the lungs. If the hole is large, the baby can have poor growth and require surgery to avoid heart failure and permanent damage to the arteries in the lungs.
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Normal Heart And Heart With Ventricular Septal Defect
Figure A shows the structure and blood flow in the interior of a normal heart. Figure B shows two common locations for a ventricular septal defect. The defect allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood in the right ventricle.
A VSD can be small or large. A small VSD doesn’t cause problems and may close on its own. Large VSDs cause the left side of the heart to work too hard. This increases blood pressure in the right side of the heart and the lungs because of the extra blood flow.
The increased work of the heart can cause heart failure and poor growth. If the hole isn’t closed, high blood pressure can scar the delicate arteries in the lungs. Open-heart surgery is used to repair VSDs.
How To Prepare For Open
Tell your doctor about any drugs you are taking, even over-the-counter medications, vitamins, and herbs. Inform them of any illnesses you have, including herpes outbreak, cold, flu, or fever.
In the two weeks before the surgery, your doctor may ask you to quit smoking and stop taking blood-thinning medications, such as aspirin, ibuprofen, or naproxen.
Its important to talk to your doctor about your alcohol consumption before you prepare for the surgery. If you typically have three or more drinks a day and stop right before you go into surgery, you may go into alcohol withdrawal. This may cause life-threatening complications after open-heart surgery, including seizures or tremors. Your doctor can help you with alcohol withdrawal to reduce the likelihood of these complications.
The day before the surgery, you may be asked to wash yourself with a special soap. This soap is used to kill bacteria on your skin and will lessen the chance of an infection after surgery. You may also be asked not to eat or drink anything after midnight.
Your healthcare provider will give you more detailed instructions when you arrive at the hospital for surgery.
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You May Experience Memory Loss And/or Brain Fog
There are a couple of things that can cause memory loss and brain fog after open-heart surgery. If you were put on bypass, it can cause these issues. It is also called pump head. Post-operative cognitive dysfunction can also cause memory loss. Both of these are usually short-term but can have the possibility of long-term effects. For the first six months, I really struggled with memory loss and brain fog. As time went on, it started to get better and I started to regain my memory and wasnt so foggy-headed.
Chop Researchers: Early Hearing Evaluation Is Crucial In Surgery Patients
Children who have heart surgery as infants are at risk for hearing loss, coupled with associated risks for language, attention and cognitive problems, by age 4. In a single-center group of 348 preschoolers who survived cardiac surgery, researchers found hearing loss in about 21 percent, a rate 20 times higher than is found in the general population.
The researchers recommend that children who undergo heart surgery have their hearing evaluated by age 24 to 30 months, to increase their chances of receiving timely medical intervention. The study appeared in the January 2017 issue of the Journal of Pediatrics.
Children born with life-threatening heart defects require a great deal of sophisticated care before and after surgery, said study leader Nancy B. Burnham, RN, MSN, CRNP, a nurse practitioner in the Division of Cardiothoracic Surgery at Childrens Hospital of Philadelphia . This study reminds healthcare providers not to overlook hearing evaluations, because early detection and intervention can reduce later problems in neurodevelopment.
The researchers performed their analysis as part of a prospective observational study of neurodevelopmental outcomes in preschool-aged children who underwent infant surgery at CHOP for congenital heart defects. The study cohort was 348 children who had a comprehensive neurodevelopmental evaluation at age 4 between 2003 and 2008.
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Newborn Cardiac Surgery Survival
Performing heart surgery on newborn babies is more challenging due to the young age and small size of the patients. By comparing newborn survival rates along with STAT category, parents can get an idea of how well the surgeons perform in the most challenging cases.
What we measure:
We compare our survival rates for newborn patients with national averages by the complexity of the surgery.
Newborn Survival By Stat Category
HIGHER IS BETTER
What it means:
At Childrens Colorado, our surgeons have extensive experience correcting heart defects in even the youngest patients some just a few hours old. Our survival rates for STAT 1, STAT 2 and STAT 5 cases are higher than the national averages. Across all STAT categories, Children’s Colorado has a newborn survival rate of 94.4% compared to a national average of 92.5%
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Technology Lessens Surgery Dangers
In an interview with Healthline, Dr. Tweddell, one of the foremost practitioners in this field, said modern technology is making infant heart surgeries safer.
We have better diagnostic imaging, better intra-operative support, and better intra-operative monitoring, he said. Post-operative care is getting more sophisticated, and we are less tolerant of a child that does not appear to be on the right track. We are more likely to get additional studies to see why they are not progressing, and may submit them for reintervention before they get too sick.
On June 30, Tweddell became executive co-director of the Heart Institute and professor of surgery at Cincinnati Childrens Hospital Medical Center. He is the former medical director of pediatric cardiothoracic surgery at Childrens Hospital of Wisconsin in Milwaukee.
With decades of experience, Tweddell knows how to counsel parents whose babies need cardiac surgery, how to involve them, and how to ease their fears.
He said the most difficult part of his job is telling parents of high-risk infants about the dangers of such procedures.
how to convey the risks of surgery without taking away hope but, at the same time, providing a realistic assessment of the risks, he said.
Its not always easy to calm an anxious parent.
If an infant needs heart surgery, parents should consider the depth and breadth of the hospitals program, Tweddell added.
Types Of Congenital Heart Defects
Congenital heart defects change the normal flow of blood through the heart. This is because some part of the heart didn’t develop properly before birth.
There are many types of congenital heart defects. Some are simple, such as a hole in the septum that allows blood from the left and right sides of the heart to mix, or a narrowed valve that blocks blood flow to the lungs or other parts of the body.
Other defects are more complex. These include combinations of simple defects, problems with where the blood vessels leading to and from the heart are located, and more serious problems with how the heart develops.
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Wearing Certain Types Of Clothing Might Be Hard During Surgery Recovery
Usually in discharge, they tell you to wear button-down clothing for a while, but what they dont tell you is that your skin is super sensitive and wearing tight clothing even a couple of months after might be hard. For women, wearing bras might be tough. Try to find comfortable sports bras you can unclasp or undershirts. I tend to wear bras now that dont have underwires and have a t-shirt cotton feel.
How Are Congenital Heart Defects In Infants And Children Diagnosed
Today, serious heart defects are usually detected prenatally or soon after a child is born. The majority can be diagnosed during fetal development using echocardiography, a simple, noninvasive ultrasound technique to evaluate the heart. Appropriate planning and management strategies can be put into place to provide the safest delivery and postnatal care. All newborns are screened with pulse oximetry, a test that involves placing sensors on the skin to check for low oxygen levels that may be a sign of a congenital heart problem.
Babies with a congenital heart defect may have no symptoms at all, or there may be such signs as excessive fatigue, difficulty breathing, or their lips and nails appear to have a blue tint. Some symptoms may not be apparent until a couple of days after they go home from the hospital, or they may not be detected until much later. A health care provider may suspect a problem in a child who may be experiencing abnormal heart rhythms, heart sound, or shortness of breath, among other symptoms, during a checkup.
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Family Finds A Trusted Team
After a lot of research and referrals, Gina and Kyle entrusted their babys life to a team of surgeons at a nearby medical center.
With tenacity, dedication, and grace, the surgeons used the beating-heart method when they performed the Norwood procedure on our fragile infant, Gina said. Even among HLHS infants, John was especially weak because his aorta was tiny, only a few millimeters in diameter. The surgeons enlarged his aorta, made some extra tunnels, and completely rerouted his blood flow.
They took John home at six weeks.
Once his diet could tolerate my milk, Gina said, this sweet baby boy started to breast-feed. It was awesome, nothing short of a miracle.
John remained blue in color until he was strong enough, at five months, for his second open-heart surgery, known as the Glenn procedure. Surgeons attached the superior vena cava to the pulmonary artery, allowing for more oxygenated blood.
After that surgery, he cried all night, she said. Around 4 a.m., the nurses brought in a bigger bed so I could help soothe him. Once he was cuddled up next to me, he looked me in the eye and gave me the biggest smile. We took him home about two weeks post-op, and the appointments were less frequent.
During the third surgery, the Fontan procedure, surgeons attached his inferior vena cava to his pulmonary artery. He has made tremendous progress in his recovery, his mother said, but recent lung problems presented a setback the doctors are still addressing.
Newborn Heart Surgery: It Was Awful As Soon As I Found Out I Was Hysterical
The coupleâs son Leo, who was born prematurely, was diagnosed with four congenital heart problems. Newborn heart surgery was the only way out, but as you can imagine, full of risks. The little ones parents were devastated when they heard that open heart surgery was the only chance at life their baby had.
Image: Screengrab from Bristol Post
Aimee says, âNothing can make you surrender more than having to give your child to a surgeon when thereâs a chance of death. I have never cried so much.â
âIt was a complete blur when they were telling us the risks, death was an option. Along with paralysis, infection, damage to spinal cord, stroke and internal bleeding,â shares Aimee.
She added that because Leo was born prematurely, they had to wait till he was the correct weight to conduct the newborn heart surgery on him. But had the doctors waited any longer, there was a possibility that he could have died.
The good news? Leo was successfully operated for two heart conditions, but two need to be reviewed. Aimee says, â He still has two heart conditions, which we have a review for at the end of February. Heâs still not perfect, but heâs doing really well.â
Aimee and Alex are both grateful to the team of doctors and nurses at Bristol Childrenâs Hospital for saving their little love, Leo.
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What Are The Signs And Symptoms Of Congenital Heart Defects
Many congenital heart defects have few or no signs or symptoms. A doctor may not even detect signs of a heart defect during a physical exam.
Some heart defects do have signs and symptoms. They depend on the number, type, and severity of the defects. Severe defects can cause signs and symptoms, usually in newborns. These signs and symptoms may include:
- Rapid breathing
What To Expect At Home
Your child will need at least 3 or 4 more weeks at home to recover. For larger surgeries, recovery may take 6 to 8 weeks. Talk with your child’s health care provider about when your child can return to school, daycare, or take part in sports.
Pain after surgery is normal. There may be more pain after closed-heart surgery than after open-heart surgery. This is because nerves may have been irritated or cut. The pain will likely decrease after the second day and can sometimes be managed with acetaminophen .
Many children behave differently after heart surgery. They may be clingy, irritable, wet the bed, or cry. They may do these things even if they were not doing them before their surgery. Support your child through this time. Slowly begin to set the limits that were in place before the surgery.
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How The Heart Works
To understand congenital heart defects, it’s helpful to know how a normal heart works. Your child’s heart is a muscle about the size of his or her fist. It works like a pump and beats 100,000 times a day.
The heart has two sides, separated by an inner wall called the septum. The right side of the heart pumps blood to the lungs to pick up oxygen. Then, oxygen-rich blood returns from the lungs to the left side of the heart, and the left side pumps it to the body.
The heart has four chambers and four valves and is connected to various blood vessels. Veins are the blood vessels that carry blood from the body to the heart. Arteries are the blood vessels that carry blood away from the heart to the body.