A hole in the heart of a four year old Salt Lake boy was sealed and repaired within minutes Wednesday, without the need for open heart surgery. In fact, he'll return home Thursday.
"Bring the device up through the delivery catheter, seat it on both sides, release it, and then take everything out, wake the kid up, and six hours later they're walking around."
The Food and Drug Administration has just approved the revolutionary new procedure and Primary Children's Hospital is using it on its first patients.
Science Specialist Ed Yeates reports.
This procedure is remarkable when you consider up until now, the traditional way of repairing a hole in a child's heart involved major, traumatic surgery.
Four-year-old Ethan Smith was born with a hole in the upper two chambers of his heart. Without repair, the heart will eventually wear out.
Originally he would have been a candidate for major surgery where doctors open the chest, stop the heart, cut it open, make repairs, restart it, and close everything up.
But not today!
David Smith / Ethan's Father: "THIS IS LESS INVASIVE. AND IF EVERYTHING GOES ACCORDING TO PLAN THAT IT WILL ACCOMPLISH THE SAME THING AND BE LESS TRAUMATIC TO HIM."
Ethan is wheeled in a wagon to an outpatient room. Dr. Collin Cowley feeds a catheter tube through his thigh, into a vein, and then up into the boy's heart. Once there, the catheter pops open a macron polyester patch.
The larger disc opens on the left side of the hole, the smaller on the right side.
This is a picture inside the heart at the time the repair was made.
The patches are designed to plug all sizes of holes.
Collin Cowley, M.D. / Pediatric Cardiologist, PCMC: "TWENTY-FIVE MILLIMETER IS A ONE INCH DEFECT - DEVICES GO UP TO THIRTY MILLIMETER SO ABOUT AND INCH AND THREE QUARTERS WHICH IS A PRETTY BIG HOLE."
ED YEATES: "THE PROCEDURE FROM BEGINNING TO END TAKES ABOUT TWO HOURS. BUT MOST OF THAT IS PREPARATION AND MEASURING. ONCE THE CATHETER IS IN PLACE, THE ACTUAL REPAIR TAKES ONLY TWO TO THREE MINUTES."
Ethan's only scars - two very small catheter holes on his thigh. Within six months, his own heart tissue will grow through the web material on the patch - making the seal complete.
TAMARA SMITH, ETHAN'S MOTHER: "I TOLD HIM YOU KNOW I WON'T BE ABLE TO CATCH YOU AFTER YOU GET YOUR HEART FIXED AND HE SAID I KNOW."
Upstairs at Primary, another patient, 7-year-old Tracy Layton from Idaho Falls is recovering nicely only three hours after her procedure. Eventually children here will probably be able to go home within six to eight hours.
The technique not only works extremely well - it's less expensive - 10-thousand dollars cheaper in fact than open heart surgery.
March 20, 2002
