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Marjorie Bekaert Thomas
Advances in health and medicine.
Cardiovascular Health Channel
Reported May 27, 2010

Congenital Heart Disease: New Surgery

(Ivanhoe Newswire) -- A newer surgical technique may increase the odds babies born with a severely underdeveloped heart will survive.

Congenital heart disease is the most common birth defect, which affects 1 percent of babies born every year. A normal heart has two pumping chambers, or ventricles. The right ventricle pumps blood to the lungs and the left ventricle pumps blood to the body.

A study by the National Heart, Lung, and Blood Institute (NHLBI) involved 549 newborns born with hypoplastic left heart syndrome; a severe form of congenital heart disease in which babies have a functioning right ventricle, but nonfunctioning left ventricle. Without treatment, babies often don't survive long after being born.

The study compared two surgical techniques commonly used to treat babies with hypoplastic left heart syndrome. Three surgeries are typically needed to treat the complication. The first involves implanting a shunt, or small tube, to allow blood to flow from the heart to the blood vessels in the lungs or pulmonary arteries.

In the NHLBI study, patients were assigned to receive one of two types of shunts; about half received the traditional, modified Blalock-Taussig (MBT) shunt, which involves placing the shunt from a branch off the aorta. The other patients were given a newer shunt, called an RVPA shunt, which is implanted between the right ventricle and pulmonary arteries. Both shunts were found to have advantages and disadvantages.

"We found that the right ventricle-to-pulmonary artery shunt improved the chances of being alive without a heart transplant one year after surgery. However, the benefit appears to be limited to the first 12 months, as the two shunts showed similar results after about two years," Richard G. Ohye, M.D., head, Pediatric Cardiovascular Surgery Division, University of Michigan, Ann Arbor, and lead author of the study, was quoted as saying.

After 12 months, 74 percent of infants with the RVPA shunt survived and didn't require a heart transplant, compared to 64 percent of infants with the MBT shunt. However, those with the RVPA shunt experienced significantly more complications that required additional treatment, including the placement stents or balloons to keep the shunt open. The researchers say they will continue to follow the children involved in the study.

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Source: New England Journal of Medicine, May 27, 2010

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