Closing "holes in the heart" without surgery

Closing "holes in the heart" without surgery

This week two new procedures were introduced at St. Luke’s Hospital as part of the developing programme for the treatment of children born with congenital heart defects and supported by the Department of Health.

The first procedure is designed to close a type of hole in the heart, known as an atrial septal defect - a communication between the two receiving chambers, known as atria. Until now, these defects could be treated successfully with open heart surgery but through the new techniques introduced this week, can be carried out through a 2mm hole in the upper thigh. The procedure consists of thorough evaluation of the hole in the heart using an ultrasound probe placed in the gullet. This is followed by accurate sizing using a balloon, and finally, closure of the defect with a device known as the Amplatzer device. The procedure is carried out under constant ultrasound and x-ray control. Three children were successfully treated with this technique this week at St. Luke’s Hospital, two girls aged seven and fourteen years respectively and one boy aged eight years. The advantage of this approach include the absence of a scar, no pain, no need for routine intensive care , only one night hospital stay and a very short period of convalescence.

The second procedure introduced this week at St. Luke’s Hospital is the PDA Occluder which is a plug designed to close a tube between the two main arteries, known as patent arterial duct (Patent Ductus Arteriosus). Although such abnormality has been treated in Malta previously without surgery since 1992, the new technique can be employed in small infants as well as older children. Three children were successfully treated, two girls and one boy, the youngest being 10 months old and weighing 7 Kg.

These developments have been made possible by the use of an alloy known as Nitrinol which was discovered by the American Navy in the 1960’s for submarine technology. The device used was designed by Minnesota based Prof. Kurt Amplatz who has other innovations to his name. Dr. Joe DeGiovanni, who carried out the procedures at St. Luke’s Hospital, was involved with the original clinical evaluation and is now a trainer for this technique. The device was approved for marketing in the European Community by the European Devices Agency four months ago.

Dr. J. V. DeGiovanni MD, FRCP, FRCPCH, MOM

• Qualified Malta 1973
• Consultant Cardiologist and Head of Specialty at Birmingham Children’s hospital UK.
• Also Consultant at University and City Hospitals and Honoury Senior Lecturer in Medicine at Birmingham University.
• Dr. DeGiovanni will be one of the speakers in a Paediatric Update organized by the Maltese Paediatric Association and the Postgraduate Medical Committee of the University of Malta this weekend.
• He will be proceeding to Turkey to do similar work at Istanbul University next week.