FRIDAY, April 12, 2002 (HealthDayNews) -- A newly approved device the size of quarter is making it easier than ever for doctors to plug a hole in the heart of a child.
Before, cardiologists couldn't fix some heart defects without an open-heart operation. However, the Amplatzer Septal Occluder lets children go home the same day their hearts are patched up.
"It's a huge breakthrough in being able to care for these children," says Dr. Juan Alejos, a pediatric cardiologist who uses the device at the Mattel Children's Hospital of the University of California at Los Angeles.
AGA Medical, the manufacturer of the device, has tested it for several years. The U.S. Food and Drug Administration approved it in December, and several children's hospitals immediately put it to use.
About 40,000 babies are born with heart defects each year, according to the American Heart Association. Of that number, an estimated 10 percent have a tiny opening in the wall between the two upper chambers of the heart.
The upper chambers take in two types of blood -- oxygen-depleted blood from the body and freshly oxygenated blood from the lungs. The bottom chambers then send oxygenated blood to the body and oxygen-depleted blood to the lungs for refueling.
A hole between the upper chambers lets some of the oxygenated blood slip back into the chamber that holds the blood ready to be shipped to the lungs, Alejos explains. In other words, blood that's ready to go out to the body ends up going back to the heart instead.
"The heart's doing a lot of extra work," Alejos says. "It's like sending a car with gas right back to the gas station."
The defect is present from birth, but parents often don't notice any problems for a few years, Alejos says.
"A baby or young child can compensate for it. But the older you get, the more your heart becomes stressed or strain, the more likelihood your heart will begin to (get larger) because it's having to do all this double work, double duty," he says.
Doctors usually notice the problem when the child is 3 or 4. If not treated, the result is a worsening case of congestive heart failure. "The heart begins to tire out, the blood begins backing up," Alejos says. "You have difficulty exercising, and you get tired easily."
In the past, cardiologists resorted to open-heart surgery to close the holes.
"That meant a four-day hospital stay and going on the bypass machine," Alejos says. "It means an incision around the middle of your chest, opening up the breastbone. Then there's the pain of recovery."
While children recover more quickly than adults do, they are less equipped to handle the pain and end up with a lifetime chest scar, he says.
By contrast, an operation using an occluder device doesn't require an open-heart operation. A cardiologist inserts the device using a catheter, and directs it to the hole in the heart.
When it gets inside the hole, the cardiologist expands the device so it fills the space. The hole is then plugged for good. "The tissues of the heart grow over it over time," Alejos says.
The good news is the occluder device isn't just for kids.
Dr. Frank Ing, a pediatric cardiologist and enthusiastic fan of the occluder device, even treated elderly patients at Children's Hospital in San Diego, where he works.
The appearance of older patients drew plenty of attention, he says, and officials finally told him the facility wasn't equipped to handle adults.
What To Do
See what the occluder looks like by visiting AGA Medical Corp.
Learn more about holes in children's hearts from Heart Disease Online.
