Hybrid Cardiac Procedures Save Preemie with Aortic Stenosis
When Stephanie was born on November 14, 2007, doctors at her Lexington, KY, hospital realized they were facing an emergency. Not only was she born at 32 weeks gestation, she was also suffering from critical aortic stenosis. Due to her size of only 3.5 pounds, Stephanie could not be treated with routine catheterization, nor could she be placed on cardiac bypass for open heart surgery.
The doctors sent her from Lexington to Cincinnati Children’s, where she would be treated at the Heart Center’s new state-of-the-art hybrid cardiac catheterization lab.
“The hybrid lab is ideal for tiny patients like Stephanie,” says Russel Hirsch, MD, director of cardiac catheterization at Cincinnati Children’s.
“There are many instances when a child may require simultaneous catheterization and surgery,” he explains. “This facility allows us to care for such patients in an innovative and imaginative way.”
By combining the best elements of an operating room with the imaging technology needed to perform complex catheterization procedures, the lab provides the best and safest care to children with complex conditions while minimizing the total number of interventions they may require.
Stephanie’s case is an excellent illustration of the hybrid approach. After she was rushed to Cincinnati Children’s, Dr. Hirsch worked in the hybrid cath lab with cardiothoracic surgeon Pirooz Eghtesady, MD, PhD, to treat Stephanie’s aortic stenosis.
Using the lab as a fully functioning OR, Dr. Eghtesady created an incision to expose Stephanie’s carotid artery.
Dr. Eghtesady’s incision created a direct approach to the heart for Dr. Hirsch, who then utilized the imaging technology available in the lab to thread a catheter through the carotid artery and across the aortic valve. Then he was able to successfully dilate the valve.
“The key here is that everything that can be done in the OR can be done in the lab,” says Dr. Hirsch.
Six months later, Dr. Hirsch reports, “Stephanie is doing fantastically. Her growth and development have been normal, and we are looking forward to many years before her next cardiac intervention.”
