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Little hearts, big tools


Heart defects run in my family. I lost two infant sisters to hypoplastic left heart syndrome, a congenital defect in which the left side of heart fails to develop. The defect is still known as one of the most challenging heart anomalies to treat. And just a few years back, my younger brother, a college athlete, learned that he has a bicuspid aortic valve - two flaps of tissue where three should be. Fortunately, it hasn't caused any problems yet.

Treatment options for cardiac defects have improved in the more than two decades since my sisters were born, but not as much as I thought. According to an article in today's Wall Street Journal, "hardly any of the myriad drugs and devices developed for the multibillion-dollar market for cardiovascular disease are designed with kids in mind."

This means that babies and kids get treatments designed for and tested on adults. In some cases, doctors use tools meant for adult kidneys on baby hearts - a clever example of makeshift medicine that nonetheless carries additional risks.

More than 35,000 babies a year are born with congenital heart defects. Not all require treatment, but many do, so it's somewhat surprising that doctors still have to jerry-rig solutions. At least the article offers some hope:

"An FDA advisory panel recently recommended approval of a heart valve that could be used in children. Various clinical trials, sponsored by the National Institutes of Health and other groups, aim to compare different surgical approaches and different drug regimens in children with congenital heart defects. And the American College of Cardiology next month plans to launch a registry that will allow doctors to compare the outcomes of catheter-based procedures done on children at centers around the U.S."

Such research efforts could make a huge difference for miniature hearts. See the full article for more.

Previously: Erin Digitale on safer surgery for kids
Illustration of heart with atrial septal defects by Patrick J. Lynch, medical illustrator and C. Carl Jaffe, MD, cardiologist

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