New procedure avoids open-heart surgery
by Michael Baker
MUSC Public Relations
Pediatric cardiologists brightened the life of another child last week
when Wolfgang Radtke, M.D., and Rani Bandisode, M.D., performed a rare
procedure to repair a hole in a young boy’s heart.
MUSC serves as one of only seven medical centers in the United States
currently participating in a Phase-I trial approved by the FDA.
Dr.
Rani Bandisode examines Thomas Gass, 6, in the Children’s Hospital. Thomas
underwent a procedure to repair a hole in the lower chamber of his heart.
On Jan. 20, 6-year-old Thomas Gass came from Greenville to receive treatment
for a ventricular septal defect—a hole between the right and left pumping
chambers in the lower region of his heart.
Radtke and Bandisode performed an innovative procedure marked by a departure
from typical open-heart surgery.
Rather than working making an incision in the chest, Radtke and Bandisode
inserted a catheter into a vein in Thomas’s thigh. Then, they ran the catheter
up through the vein and into the heart until reaching the septal hole.
Once the catheter was in place, Radtke and Bandisode positioned a device—called
an Amplatzer—to block the hole.
Positioned properly, the Amplatzer works by unfolding itself and sealing
the open area between the ventricles. The device is composed of two wire
mesh discs that, once implanted, block the hole while allowing the heart’s
tissue to grow around the Amplatzer.
In this way, the ventricular wall builds itself around the foundation
of the Amplatzer.
In addition to substituting for more invasive open-heart surgery, the
catheter-based procedure affords patients a much shorter recovery time.
Bandisode and Radtke performed the procedure on a Tuesday morning, and
Thomas left the hospital on Wednesday afternoon.
Such benefits provide a measure of added comfort for the patient, but
the procedure’s effectiveness remains its most important characteristic.
Bandisode explained that the hole in Thomas’s heart sat directly below
a crucial valve; similar scenarios proved resistant to treatments
in the past.
“Other attempts at plugging holes in similar locations within the heart
were unsuccessful,” she said. “In each case, the procedure affected the
valve’s functional competence, compromising the proper circulation of blood
throughout the heart.”
In Thomas’s case, however, Radtke and Bandisode implanted the Amplatzer
without affecting the neighboring valve in any way. The operation stands
as the first such endeavor to be successfully completed in the Southeast.
The timing of the procedure also was very important, according to Radtke.
“The defect forced Thomas’s heart to work almost twice as hard as it
should have,” he explained. “At his age, Thomas could tolerate the strain,
but later in life, he would have experienced significant trouble.”
With the Amplatzer firmly in place, Thomas returned to Greenville the
day after his operation. Meanwhile, Radtke and Bandisode performs four
more Amplatzer operations during the remainder of the week.
Helping children remains the mission of any pediatric cardiology unit.
But with the help of innovative procedures and new technology, MUSC continues
to make strides toward gentler, more efficient patient care
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