Hypoplastic left heart syndrome (HLHS)
Research & Innovation
Children’s Hospital Boston is a world pioneer in the development and use of innovative fetal cardiac intervention to treat hypoplastic left heart syndrome (HLHS). Thanks to Children’s research and refinements of technique, our Advanced Fetal Care Center offers the world’s largest and most experienced fetal intervention program for HLHS.
In addition, a significant amount of the groundbreaking cardiac research being conducted at Children’s aims to refine and advance open heart surgery and catheterization procedures to correct congenital heart defects in newborns and young children.
Cardiac surgery research
Members of the Children’s Cardiac Surgery Research Laboratory—a multidisciplinary team of basic and applied research investigators who hold faculty appointments at Harvard Medical School—are studying the mechanisms of heart disease and new treatments for children with congenital heart defects.
Children’s is a world leader in opening new avenues of “translational research,” bringing laboratory advances to the bedside and doctor’s office as soon as possible. Senior medical staff members of the Department of Cardiology participate in clinical research activities, and many do laboratory research, as well.
Learn more about current projects in heart research.
Reawakening the heart’s regenerative capacities
The problem: Kids with congenital heart defects sometimes suffer from heart failure, meaning their hearts can’t pump adequately. And since heart muscle has very little growth capacity after birth—nowhere near enough to fix a severe cardiac injury—heart transplant is often the sole treatment option.
Innovative solution: Researchers in Children’s Cardiovascular Program have discovered a growth factor, called neuregulin1 (NRG1), that can reawaken the heart’s regenerative capacities, and may be able to strengthen the heart after a heart attack and in children and adults with heart failure.
NRG1, which is involved in the initial development of the heart and nervous system, spurred heart-muscle growth and recovery of cardiac function when injected systemically in rats. Preparations are underway to test the growth factor in humans. Doctors now envision a time when patients may receive monthly infusions to build up their hearts.
Creating new ways to perform surgery
Problem: When surgeons perform heart surgery on a baby, they need to open the infant’s chest and stop her heart—an invasive, lengthy procedure that can cause life-threatening complications. Pedro del Nido, MD, chief of Cardiac Surgery at Children’s, had to perform surgery on his tiny patients using this method, or come up with a way to improve it.
Innovative solution: Del Nido decided to develop a way to perform surgery on a still-beating heart. But he needed two things that didn’t exist: superior imaging tools that could show the structures inside the heart while it’s beating, and tiny instruments to perform the intricate surgery.
So, he borrowed technology from the videogame industry and developed stereo-rendered 3-D ultrasound imaging that allows surgeons to see inside the beating heart as a hologram.
Del Nido also designed new instruments. One is a millimeter-sized tool that extends into the heart through needle-sized incisions. Using a joystick controller and real-time imaging, a surgeon can now navigate through the beating heart’s chambers to remove blockages, repair faulty valves and close leaks.
The other new instrument is a cardioport device that allows instruments to be safely introduced into the cardiac chambers without the usual risks of blood loss or an air embolism.
Results: Del Nido’s 3-D tool appears not only to provide superior imaging, but also to yield faster surgery times. Researchers using it to operate on pigs with congenital heart disease performed the procedure 44 percent faster than before. Dr. Del Nido’s cardioport will soon be tested in clinical trials and will facilitate further development of similarly novel instruments for heart repair.
Del Nido’s newly-developed cardioport
will someday make possible faster, less invasive heart surgery.
|History of innovation|
|In 1938, Children’s cardiac surgeon Robert Gross, MD, performed the world’s first successful surgery to correct a child’s heart defect. Since that time, we have gained recognition around the globe for our leadership in pediatric cardiology and continue to make critical advances in the field. In 2010, U.S.News & World Report named Children’s cardiology and cardiac surgery programs the best of any pediatric hospital in the country.|