Inside Pediatrics Spring 2025

CARDIOLOGY

A New Blueprint for High-Risk

Newborns

FLOW RESTRICTOR DEVICE SHOWS PROMISE FOR HELPING PATIENTS WITH HYPOPLASTIC LEFT HEART SYNDROME

B abies born with hypoplastic left heart syndrome, in which the left side of the heart doesn’t fully develop and thus can’t pump blood very well, typically require open-heart surgery soon after birth or a hybrid surgical approach combining stenting and open surgery to establish systemic blood flow and control pulmonary blood flow. Given the already fragile state of the infant, however, neither approach is optimal, and both have high mortality rates.

Doctors at Children’s of Alabama are helping these children by using an internal pulmonary flow restrictor created by modifying a microvascular plug. They form the device by cutting a tiny hole in the Gore-Tex covering of the microvascular plug originally designed to close blood vessels in children and adults. With this use of the device, they are able to postpone surgery for months until the infant is bigger and stronger while still controlling pulmonary blood flow in a completely non invasive manner. “The problem we’re addressing is over-circulation of blood to the lungs,” explained pediatric cardiologist Mark Law, M.D. “Traditionally, it requires open-heart surgery to place a band around the pulmonary artery to reduce blood flow. However, this surgery is invasive and can be very stressful for the baby.”

12