Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Ground-breaking study to improve quality of life and outcomes for kids born with heart defect

27.05.2010
National study led by the University of Michigan’s Congenital Heart Center

A trial on shunts used to direct blood flow to the lungs, led by researchers at the University of Michigan's C.S. Mott Children's Hospital, will lead to better outcomes for kids worldwide born with hypoplastic left heart syndrome, the most common severe heart birth defect.

Under the leadership of the University of Michigan, the first multi-institutional randomized prospective trial ever conducted in congenital heart surgery was just completed by the Pediatric Heart Network with funding from the National Heart, Lung, Blood Institute.

Kids with the hypoplastic left heart syndrome have hearts that don't develop properly in the womb. Because the left side of the heart fails to develop, they are often referred to as being born with half a heart.

This groundbreaking study is published in the May 27, 2010 issue of the New England Journal of Medicine. Richard G. Ohye, M.D., Division Head of the Pediatric Cardiovascular Surgery at the University of Michigan's C.S. Mott Children's Hospital, is the study chair and lead author.

"Congenital heart disease is much more common than people realize," says Ohye. "Heart abnormalities are the most common birth defect, and it occurs in almost one out of every 100 live births."

Twenty years ago, doctors were unable to save these children with hypoplastic left heart syndrome. Today, because of efforts by the University of Michigan Congenital Heart Center and other centers like it around the world, most of these infants can be saved through a series of three operations that can be compared to re-plumbing their heart.

Research into this congenital defect has been rare because most centers do not see enough patients with any one diagnosis to be able to effectively study it. Hypoplastic left heart syndrome occurs in about 1,000 kids every year in the United States and it accounts for roughly about 8 percent of all different congenital heart defects.

"We can't really rebuild the heart so we have to make do with what there is -- the one pumping chamber," Ohye says. "So we re-plumb the heart so that the kids can get by with just the single ventricle or pumping chamber."

The treatment of hypoplastic left heart syndrome requires three operations and the first one is done around the time of birth, the second one at about four to six months of age and the last one at 18 to 24 months of age.

The University of Michigan has had a pioneering role in the treatment of hypoplastic left heart syndrome.

Prior to the early 1980s, there was no operation for it at all, so all the kids unfortunately died as newborns. Since that time, survivals have dramatically improved. Initially, they were quite low. During the 1990s, hospital survivals for the first operation were only about 40 percent. Now, at experienced centers, they're up above 90 percent.

In the first stage operation for hypoplastic left heart syndrome, there are two different versions. Researchers were interested in finding out which had a better survival rate.

One version gets blood directly from the heart through a tube, or shunt, to the artery to the lungs. The other allows the blood first to exit the heart through the reconstructed aorta and then bring the shunt from that reconstructed aorta over to the artery to the lungs.

"What we found was that the shunt that went directly from the heart to the artery to the lungs did better over the course of the first year," Ohye says. "We also found that they had tended to have a few more complications though, and so I think the jury's still out over the long run which is going to be better."

"We're going to continue to follow these kids," says Ohye. "We're almost up to a four-year follow-up at this point and then we'll continue to follow them and plan on looking at them again when they're about 8 or 10 years old."

This research also is significant because it is the very first randomized prospective trial ever done in congenital heart surgery. The study enrolled 555 kids and will provide a tremendous opportunity to observe them all the way into adulthood and follow them and see how they do.

"It is important to test anything we do to manage our patients in a rigorous scientific way, and it's the first time that we've ever gotten together, many centers - 15 in this case - and agreed that this was really important to do," Ohye adds. "We showed that we can do it and that we believe that it's important to do for our kids."

"Not only did the study answer an important question about how we care for them at birth, but it's going to continue to help us understand how we take care of them throughout their lives," says Ohye.

Additional authors paragraph: Richard G. Ohye, M.D., Lynn A. Sleeper, Sc.D., Lynn Mahony, M.D., Jane W. Newburger, M.D., M.P.H., Gail D. Pearson, M.D., Sc.D., Minmin Lu, M.S., Caren S. Goldberg, M.D., Sarah Tabbutt, M.D., Ph.D., Peter C. Frommelt, M.D., Nancy S. Ghanayem, M.D., Peter C. Laussen, M.B., B.S., John F. Rhodes, M.D., Alan B. Lewis, M.D., Seema Mital, M.D., Chitra Ravishankar, M.D., Ismee A. Williams, M.D., Carolyn Dunbar-Masterson, B.S.N., R.N., Andrew M. Atz, M.D., Steven Colan, M.D., L. LuAnn Minich, M.D., Christian Pizarro, M.D., Kirk R. Kanter, M.D., James Jaggers, M.D., Jeffrey P. Jacobs, M.D., Catherine Dent Krawczeski, M.D., Nancy Pike, R.N., Ph.D., Brian W. McCrindle, M.D., M.P.H., Lisa Virzi, R.N., M.S., M.B.A., and J. William Gaynor, M.D., for the Pediatric Heart Network Investigators

Funding source: Funded by the Pediatric Heart Network

Journal reference: N Engl J Med 2010;362:1980-92

Margarita Bauza | EurekAlert!
Further information:
http://www.umich.edu

More articles from Studies and Analyses:

nachricht Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

nachricht The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Osaka university researchers make the slipperiest surfaces adhesive

18.10.2017 | Materials Sciences

Space radiation won't stop NASA's human exploration

18.10.2017 | Physics and Astronomy

Los Alamos researchers and supercomputers help interpret the latest LIGO findings

18.10.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>