How to Preserve the Miracle of Life for More Families
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 babies are born in the United States with congenital heart defects. Many will not make it to their first birthday. Fortunately, several breakthrough technologies have emerged in recent years that are poised to save many of these babies. It’s time we put them to more widespread use.
Congenital heart conditions are the most common birth defects in this country, afflicting about 40,000 babies — nearly 1 percent of births — each year. 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. Any one of these problems can make it more difficult for the heart to pump blood and feed oxygen to the rest of the body.
Some heart defects can be treated with medicine; others require surgery. But in too many cases, the array of current health-care technologies available for treating infant heart defects is insufficient.
Medical devices, including those for the heart, are often designed for and tested in adults. For the most part, 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 doctors and engineers at UCLA are developing miniaturized stents more suitable for opening a too-narrow aorta in a newborn infant that also have a special capability of resorbing over time in the baby’s body, so that as the baby grows, the stent is no longer present.
This list isn’t exhaustive — scientists and researchers are on the brink of other discoveries to meet needs for these youngest patients.
I’ve dedicated most of my professional life to trying to bring effective health-care technologies to babies. 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 and treated with medications. 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 everyone involved in our health-care system to work together 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.)