Slower can be better

Reducing radiation exposure during heart catheterization procedures

cardiac cath reducing radiationA cardiac catheterization is a procedure performed by a cardiologist to diagnose and often treat heart conditions. Many patients with congenital heart disease require cardiac catheterizations. During catheterization procedures, we use fluoroscopy to obtain real-time moving images of your heart.

Fluoroscopy is basically a series of x-rays that are played very quickly. It’s similar to how movies work – when the still images are played back quickly, they produces a moving image.

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Finding better ways to compare pediatric heart care quality

comparing pediatric heart care qualityThe fields of pediatric cardiology and cardiac surgery have come a long way. Today, conditions that were universally fatal as recent as 30 years ago can now be successfully treated, allowing children with congenital heart disease to thrive into adulthood.

However, we also know that there is much more work to be done to ensure that all children with heart disease have access to the highest quality care. One thing that is important is to be able to identify and learn from those hospitals with the best outcomes who are providing the highest pediatric heart care quality to children with heart disease.

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Transition Readiness for Congenital Heart Disease Patients

Children born with congenital heart disease are thriving thanks to advances in diagnosis and treatment. Currently, 85 to 90 percent of these patients survive into adulthood. That’s great news. Unfortunately, studies have shown that as many as 50 to 75 percent of these patients fail to follow up with their care as they become adults and are then more likely to be admitted to the emergency room with urgent problems.

We studied 165 patients from 13- to 25-years-old to assess their readiness to transition to adult care. Patients completed a Transition Readiness Assessment and Pediatric Quality of Life Inventory using an e-tablet. For patients under age 18, we also had a parent complete a Transition Readiness Assessment that helps us better understand the parent’s perceptions of the child’s transition knowledge and behavior.

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Patrick Nolan’s story: Managing congenital heart defect from birth to adulthood

A fix for congenital hearts without another zipper scar

Approximately 40,000 babies are born each year with congenital heart defects — the most common type of major birth defect in the U.S. But, a new valve being used at the University of Michigan’s C.S. Mott Children’s Hospital Congenital Heart Center is helping patients delay or avoid multiple open-heart surgeries.

Patrick Nolan, left,hiking with friends.

Patrick Nolan, left, hiking with friends.

The new Melody Transcatheter Pulmonary Valve is inserted through a catheter into a vein in the patient’s leg during a heart catheterization, rather than an open-heart procedure. On Sunday, U-M’s Dr. Aimee Armstrong presented data to the American College of Cardiology that reaffirmed the safety and efficacy of the valve, which has been FDA approved for Humanitarian Use Device designation since Jan. 2010. Read here for more details on that presentation. C.S. Mott Children’s Hospital’s Congenital Heart Center was the first hospital in the state, and one of the first in the country, approved to use the valve in patients. 

25-year-old Patrick Nolan is one of those patients. Under the care of Dr. Armstrong, Patrick was able to get the heart valve he needed in 2011 without having to undergo yet another open-heart procedure. Today, he is a hard-working med student hoping to become a pediatric cardiologist, in part due to his experience as a cardiac patient and the dedicated doctors he’s met along the way. 

Patrick shares his inspiring story…

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Imagining a better pacemaker

Multiple surgeries to replace batteries and leads could become a thing of the past for children with pacemakers

leadless pacemakerPacemakers have made a huge difference for children with congenital heart defects.  Here at the Congenital Heart Center we generally implant pacemaker devices in children each week, for conditions ranging from slow heart rates they were born with to abnormal rhythms arising after complicated heart operations.

Pacemakers are often needed for children with a type of arrhythmia in which heart rhythms are too slow. The device follows the child’s heart beat and keeps it from falling below a certain rate.

While these life saving devices have made a positive difference for countless children since initially developed in 1958, they are not without disadvantages.  One major weakness in our current pacemaker models is the need for battery replacement.  Although a pacemaker uses only microwatts of power, the batteries currently have a lifespan of 6-12 years.  This means that a person with a pacemaker implanted during childhood could require as many as 10 surgeries in their lifetime just because of depleted batteries.

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Erasing the need for heart transplants

U-M doctors are exploring ways to grow heart tissue for patients, from their own skin cells

Above: Heart tissue created from pluripotent stem cells pulse in a petri dish in Dr. Si’s research lab.

It may sound like a plot point from a sci-fi thriller, but turning skin cells into heart tissue is what Ming-Sing Si, MD, is doing in his research lab at University of Michigan C.S. Mott Children’s Hospital. And one day, it might eliminate the need for heart transplantation.

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