Heart Care (Cardiology)

World-Class Surgery Offers Big Help for the Littlest Hearts

About two-thirds of patients with critical heart disease are diagnosed as infants. So it’s often the tiniest hearts that need the most help—and as soon as possible. But thanks to advanced technology and our expert team of Nemours cardiac specialists, most children born with a congenital heart defect—even newborns only hours old—can be quickly diagnosed and treated right when it matters the­ most.

Our heart surgeons at the Nemours Cardiac Center (located at Nemours/Alfred I. duPont Hospital for Children in Wilmington, DE) are right at the forefront, contributing to the incredible ongoing advances in cardiac surgical management. Now, reconstructive heart surgery can help virtually all patients with structural heart disease, even the most complicated.

No matter what your baby’s diagnosis or predicted outcome, we do whatever it takes to improve the lives and the longevity of every patient we see. During 2009, we had much lower-than-expected cardiac surgery mortality (death) in newborns and infants, compared to the national average provided by the Society for Thoracic Surgeons’ congenital database. That is, we have far fewer deaths in babies (under 12 months old) who received heart surgery, compared to the national rate at other pediatric facilities for the predicted number of deaths in babies with similar conditions who received heart surgery. Our rate was 3.7% of the infants who received heart surgery, compared to the national predicted rate of 5.8%.

 

Of course, each baby and child we treat is precious to us. By specializing in early detection and repair and using the latest advances in technology and research, we can give top-notch care to every child who needs our help.

How We Do It

At Nemours, we’ve become a leader in minimizing the number of operations our young patients need. The techniques and advances we use can help babies and children avoid the trauma and recovery time of open-heart surgery. Our treatment options improve the outlook for scores of kids—with less discomfort and shorter hospital stays. And duPont Hospital for Children is actually one of only a mere handful of centers in the United States where certain treatment capabilities are available.

We’re able to ensure that even our smallest, most vulnerable patients with congenital heart defects can live longer, with a better quality of life—by providing round-the-clock care from our highly specialized cardiac intensive care team (including cardiac anesthesiologists and intensivists), dedicated entirely to the unique challenges of childhood heart abnormalities.

If your unborn baby has a heart defect, close coordination among specialists is also critically important. The Nemours Cardiac Center’s fetal cardiology team works with your obstetrician and/or perinatologist (a doctor who specializes in high-risk pregnancies) to help plan for the evaluation and treatment of your baby’s heart condition before and after birth.

Through our new Nemours Partners for Perinatal Management Program, early in-utero diagnosis (when your baby is still in the womb) offers you invaluable time to prepare emotionally and to make sound medical and financial arrangements for your child’s care. The Cardiac Center staff is here to help educate and guide you through the process of understanding your baby’s heart defect, what will happen after delivery, and what surgical or non-surgical procedure may be required to remedy the problem.

Our goal is to give every child with every kind of heart condition, from the teeniest preemies on up, the very best possible chance for a healthy future.

 

Faster Echocardiogram Results Mean Earlier Diagnosis

When you have a child with a heart problem, the quicker you can find out what's going on, the better. At our Nemours Divisions of Cardiology we take early detection and treatment of children’s heart conditions very seriously. So when your child gets cardiac tests at Nemours, we make sure your primary care physician has the accurate, complete results to inform you sooner rather than later.

Echocardiography (or “echo”) is our most frequently used imaging tool. This specialized form of ultrasound builds a picture of the heart using sound waves. It examines each heart chamber, heart valve, artery, and vein associated with the heart (even tiny structures such as the coronary arteries).

At Nemours Children’s Clinic, Pensacola we get your child’s ECHO results fast. After the pediatric cardiologist interprets your child’s ECHO, the results are immediately sent to your physician. This saves you from wondering what’s going on, waiting days—even weeks.

Nearly three-quarters (72%) of our outpatient echocardiogram reports are sent to the ordering physician within 3 hours. Less than 5% of our ECHO results come more than 24 hours after the procedure was performed. And that means you can get the diagnosis your child needs right away, without any delay in treatment. If further pediatric cardiology expertise is required, the same physician that interpreted the echocardiogram should be available for further consultation and explanation.

The Tissue Engineering & Regenerative Medicine (TERM) Lab investigates pediatric disorders affecting muscle. The overall goal is to improve health outcomes for children with acquired and congenital diseases associated with muscle malformation or malfunction, including cardiac and vascular muscle insufficiency in patients with congenital cardiovascular disease (CCD).

The Nemours Cardiac Center performs more than 200 surgeries each year to treat CCD in children. Although these surgical treatments have become quite advanced, there are four critical areas for improvement:

1. Develop alternatives to organ transplantation and non-adaptive synthetic grafts. There is a significant need for advanced cardiovascular implants for use in children. Along with members of the Nemours Cardiac Center and colleagues from the University of Delaware, the TERM lab applies advanced concepts in cellular physiology and materials science engineering to translational research aimed at developing biosynthetic implants and regenerative therapies for children with cardiovascular disease. Two studies are currently underway:
   1. Biomaterials for cardiovascular tissue engineering
   2. Molecular design of advanced biomaterials
2. Improve tissue survival and function. It is critical to sustain tissue function after invasive procedures, which may cause damage directly or indirectly. Collaborations between team members of Nemours Cardiac Center and colleagues at the University of Delaware continue to evaluate the roles of specific protein pathways in attenuating tissue damage.
3. Improve diagnostics for post-surgical outcomes. The TERM lab has established a post-surgical diagnostic test to determine b-type natriuretic peptide (BNP) levels for use in clinical evaluation of children treated for CCD. Studies to aid in the development of additional diagnostic tests are underway.
4. Improve post-surgical therapy. Many children facing CCD receive long-term treatment with anti-coagulants. The TERM lab is working to develop advanced anti-coagulation therapies based on the novel biomaterials used in the lab.

Resources from Nemours KidsHealth.org

• Arrhythmias (for Parents) 
• Arrhythmias (for Teens) 
• Atrial Septal Defect (for Parents) 
• Atrial Septal Defect (for Teens) 
• Coarctation of the Aorta (for Parents) 
• Coarctation of the Aorta (for Teens) 
• Congenital Heart Defects (for Parents)
• If Your Child Has a Heart Defect (for Parents)
• Ventricular Septal Defect (for Parents)
• Ventricular Septal Defect (for Teens)
• When Your Child Needs a Heart Transplant (for Parents)

Parent Support Services

• Caring Bridge
• Nemours’ Family Advisory Council
• Ronald McDonald House of Delaware