Infants born with a severely underdeveloped heart who undergo a newer surgical procedure are more likely to survive their first year and not require a heart transplant than those who have a more traditional surgical procedure, according to a report by researchers supported by the National Heart, Lung, and Blood Institute (NHLBI), which is part of the National Institutes of Health. The study of 549 newborns, however, suggests that after the first year, the two surgical procedures for the relatively rare condition yield similar results.

The Single Ventricle Reconstruction (SVR) Trial is the largest clinical trial to compare treatments for congenital heart disease, and the first North American, multi-center, randomized trial of surgical therapy for congenital heart disease patients. Results are published in the May 27, 2010, issue of the New England Journal of Medicine. An editorial accompanies the article.

Congenital heart disease is the most common birth defect. Every year, about 1 percent of babies are born with abnormally formed hearts. The normal heart has two pumping chambers called ventricles. The right ventricle pumps blood to the lungs, and the left ventricle pumps blood to the body. This trial studied babies born with a severe form of congenital heart disease in which babies are born with a functioning right ventricle and a small, underdeveloped, nonfunctioning left ventricle. The condition is sometimes referred to as hypoplastic left heart syndrome. Without treatment, these babies usually die shortly after birth.

The SVR Trial compared for the first time two surgical procedures that are commonly used to treat babies born with only the functioning right ventricle to determine whether one procedure improves outcomes more than the other. The SVR Trial was conducted at 15 North American clinical sites that are part of the NHLBI’s Pediatric Heart Network

“Rigorous comparison of patient outcomes is critical to fully understanding the risks and benefits of different interventions,” said NHLBI Acting Director Susan B. Shurin, M.D., a board-certified pediatrician. “To conduct meaningful clinical research on rare conditions, however, we need collaboration among multiple study sites. This study demonstrates that through consortia such as the NHLBI’s Pediatric Heart Network, we can accelerate our ability to provide needed evidence on the best ways to care for some of our most vulnerable patients.”

In general, three surgeries are needed to treat a single right ventricle. The first procedure, called the Norwood procedure, is usually performed within the first two weeks of life and is one of the highest risk procedures in congenital heart surgery. A shunt, or small tube, is implanted to provide a connection for blood to flow from the heart to the blood vessels in the lungs, or pulmonary arteries, so that blood can pick up oxygen and release carbon dioxide. Children later undergo a second surgery at 4 to 6 months of age, and a third procedure, known as the Fontan procedure, at 18 to 36 months. The operations are staged to allow the child to grow large enough that the corrective procedures can be performed. Heart transplantation may be required for children with single ventricles when surgery and other treatments fail…. (more…)

That’s why they are excited about new technology that will provide doctors at Banner Del E. Webb Medical Center with swift and detailed information about a patient’s condition before arriving at the hospital.

When firefighters are called to assist someone with a heart attack, they need only connect the person to a Medtronic Lifepak monitor and press a button to communicate a patient’s condition to hospital staff.

Alerts are sent to doctors’ smartphones and hospital computers. Included is a detailed chart of the patient’s heart rhythms. By the time firefighters deliver the patient to the hospital, the hospital is prepared. Hospital staff can bypass a diagnosis and begin treating the patient when he or she is rolled into the emergency room or cardiac catheterization lab.

Previously, firefighters described the patient’s condition to a doctor who would assess the patient upon arrival, slowing down the treatment process.

“The earlier we open up the artery, the more muscle we can save,” said Manoj Rawal, chief cardiologist at Del E. Webb. “It can make a huge difference.”

Stan Garretson, 74, says he is proof.

The Nebraska resident was visiting his sister in Surprise recently when he awakened with chest pains. Garretson’s wife, Ellen, called 911.

Four firefighters from Station 301 in east Surprise arrived and hooked Garretson up to the monitor and hospital staff received notifications seconds later, said Nathan Lewis, pre-hospital coordinator for Del E. Webb.

Everyone was ready when Garretson arrived at the hospital on Feb. 24. The new technology meant Garretson got the most necessary treatment about 15 minutes earlier than he would have in the past, Rawal said…. (more…)

Although an extra cup of coffee may make you feel like your heart is racing, researchers have found that drinking more coffee on a daily basis reduces your chances of dangerous irregular heartbeat, according to a Kaiser Permanente study.

The study included 130,054 adults who drank four or more cups of coffee per day. The results showed that compared to non-coffee drinkers, they lowered their risk of being hospitalized for irregular heartbeats by 18 percent. Researchers also concluded that even those who drank a lower amount of coffee (1-3 cups a day) were still 7 percent less likely to have irregular heartbeats…. (more…)