Heart surgery on babies who are still in the womb, 3D plastic models of actual babies’ hearts that allow surgeons to plan their surgery, and biodegradable heart stents are among the major developments on the way for pediatric cardiology patients.
While they might sound like something from a science-fiction movie, all these developments will be discussed during a congenital cardiac study day on Thursday in Ireland, reported the Irish Times on Tuesday.
“There have been incredible strides in paediatric cardiology over the past 40-50 years, but in the past two decades there have been immense strides, particularly with treating serious congenital abnormalities,” according to Dr. Colin McMahon, a consultant paediatric cardiologist at Crumlin, Ireland, who will speak about the future of the specialty during the study day.
McMahon will be covering five key future areas in his talk.
The first is foetal intervention, where the technology now exists to diagnose babies antenatally, at 18-20 weeks, with many different forms of heart defects such as hypoplastic left-heart syndrome, in which the left ventricle of the heart is severely underdeveloped.
Several centers in the US, UK and Germany are now looking at foetal intervention in these patients – that is, operating on the baby in the womb – with studies underway on foetal catheterisation, where a balloon catheter is inserted through the mother’s abdomen into the foetus’s aortic valve to see if it will help the left ventricle to grow.
“In Ireland we have a relatively small population so even if we identify patients who would benefit from that procedure, it is more likely we would refer them to a larger center in the UK,” he says.
Another major field of development is 3D printing of complex congenital hearts, says McMahon. This involves taking a CT scan of the patient’s heart and then using a computer program and 3D printer to generate a plastic 3D model.
Crumlin is involved in a pilot program on this technology and sends its data to a lab abroad, which sends back the heart model.
“I predict that in the future all children with very complex anatomy will be able to have a 3D model of their heart printed so that the surgeon can assess if they can perform a specific operation; they could, potentially, rehearse the operation on the model, and also show the parents what can be done,” he says.
Another major development in paediatric cardiology is the development of implantable ventricular assist devices, which are mechanical pumps used to support heart function and blood flow in people who have weakened hearts.
These devices help patients who need a transplant to survive outside the hospital until they get a new heart: or, with some patients, they remove altogether the need for a transplant and allow them to lead a relatively normal life, which McMahon says is vital given the limited available pool of donor hearts.
Cardiac catheterisation is another area of cardiology that is seeing great developments.
Several companies are now developing stents that are biodegradable, according to McMahon.
These have specific benefits for children as the stent can do its work and degrade after three to six months, allowing the child’s heart vessel to grow without the need for multiple operations.