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For several decades doctors have been trying to find ways to close holes in
the heart without the need for open-heart surgery.
Now, pediatric heart specialists at The Children’s Hospital at The
Cleveland Clinic have a completely metal-free patch that uses the body’s own
healing power to seal up the hole. This option was especially appealing to the
parents of seven-year-old Kelly Horn.
Kelly was diagnosed with a special kind of hole in her heart, called an
atrial-septal defect or ASD, which is located between the heart’s left and
right filling chambers. Without repair, oxygen-rich blood can back up into the
lungs, causing breathing difficulty, heart rhythm problems, heart failure or
even stroke.
Although surgery was once standard for the four percent of children like
Kelly born with ASD, Kelly and her family were offered three non-surgical
treatment possibilities. The option they chose, the "transcatheter
patch," is made of stretchy polyurethane foam that bonds to the hole’s
edges without sutures or wire.
Placed against the heart defect, the patch is held in place for 48 hours by a
small balloon. Gradually the patient’s own tissue grows over the patch, making
it stick to the edges of the hole. The tissue continues to grow over several
months, eventually covering the patch.
This treatment option also appealed to the Horn family because Kelly has a
nickel allergy, discovered when she developed a reaction to nickel earrings.
Although the presence of nickel in the metal-based devices has not been shown to
cause significant problems, Kelly’s parents felt more comfortable not having
nickel or any other kind of metal in her heart.
After the procedure, Kelly’s mother kept her active daughter in bed for two
days in the hospital, while the patch fused with the lining of Kelly’s heart,
permanently sealing the hole.
"We feel that this patch closure is a great improvement. It’s almost
like having the body’s own tissue covering the defect," says Lourdes
Prieto, M.D., the interventional pediatric cardiologist with the team who
performed Kelly’s procedure.
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