Physician discusses damaged fetal hearts
By Ben Baynton, staff writer    
Posted on November 13, 2006

Louise Wilkins-Haug (‘76), medical director of the Center for Fetal Medicine and Prenatal Genetics at Brigham and Women’s Hospital in Boston spoke Friday on how to repair damaged fetus hearts.

“[These babies] are born with half their heart” Wilkins-Haug said. “It’s a 100 percent lethal condition.”

This is called hypoplastic left heart — a condition in which the left side of the heart is underdeveloped and does not pump enough blood to sustain the fetus once it is born.
 
Previously, there were only three options for physicians to correct a hypoplastic heart. The first is to ease the death of the fetus, also known as compassionate care. The second is heart transplant for the fetus, which involves cutting open the womb and transplanting the heart. This is extremely difficult and has a low survival rate. The third option is a series of operations to make the heart able to sustain the baby using only the right side of the heart.
 
“It involves three open-heart surgeries up until about the age of one-and-a-half,” Wilkins-Haug said.

But that was not the only problem with this method. The children who have undergone this procedure tend to suffer from severe heart problems.

Wilkins-Haug and her colleagues wanted to find a better way to preserve the lives of these fetuses.
 
In researching hypoplastic left heart, they determined that there were several different types of the disease.

What Wilkins-Haug and her colleagues determined was that in some fetuses, hypoplastic left heart was caused by a blockage that prevented blood from flowing to the left side of the heart.
 
Using a small needle the thickness of a string of spaghetti, Wilkins-Haug and her colleagues would pierce the heart of the fetus through the abdomen of the mother.

“The important thing is that the uterus [the womb] is not cut,” Wilkins-Haug said.

Through the needle, the surgeons would then insert a wire with a balloon attached to the end. It is incredibly tiny and used for other heart-related medical procedures in adults.

The balloon would then be blown up, making the passage for the blood bigger.

“There’s a much greater flow from the left ventricle,” Wilkins-Haug said. This means the left half of the heart has increased blood flow and the fetus has a chance at survival.

“We have been able to improve the chance the baby won’t die in the delivery room,” Wilkins-Haug said.

There were other benefits, too.

In all the other ways of repairing the heart of the fetus, the mother ends up in the intensive care unit, but with the method Wilkins-Haug and her colleagues formulated, the mother never goes to the ICU and leaves the hospital within two days.

“When I first trained as a physician, all we had was compassionate care,” Harrisonburg physician Les Burt said.

Those who attended the lecture were impressed with the presentation and the work that Wilkins-Haug has done.

“I thought the presentation was really good,” senior Ashley Smith said. “You saw how it worked.”

Biology graduate student Teresa Pelletier said: “Anybody could have understood this presentation easily. It was excellent.”