TMC PULSE

t m c » p u l s e | j a n / f e b 2 0 1 6 15 O n a recent Thursday morning, a nurse anesthetist held open the door to Operating Room No. 25 for William Douglas, M.D., a pediatric cardiothoracic surgeon affiliated with Children's Memorial Hermann Hospital and chair of the Division of Pediatric Cardiovascular Surgery at McGovern Medical School at UTHealth. His patient had already been prepped by the surgical team, who paused and individually stated their names before assuming their respective roles for the 2.5-hour procedure ahead. Douglas would be opening up the chest of a young baby whose heart was no larger than the size of a plum. The baby was born with a congenital heart defect (CHD) that disrupted the directional flow of the arteries, and Douglas and his team were tasked with re-routing the blood so the patient's circulatory system would function properly. The procedure required the creation of a small hole between the upper two chambers of the heart as well as the placement of a shunt between the pulmonary arteries and the aorta; without the surgery, blood would continue to bypass the lungs and the patient would not survive. The field of fixing children's hearts is at once specialized and comprehensive—and vastly different from the world of adult cardiology. The focus is not acquired heart disease but rather a malformation of the organ itself. Pediatric cardi- ologists and cardiovascular surgeons are skilled in handling these organs that, while mechani- cally and anatomically are nearly identical to the adult heart, present the challenge of being min- iaturized. Moreover, congenital heart defects, also known as congenital heart disease, can run the gamut of potential malformations: leaky or blocked valves, holes in the heart's chambers B y A l e x a n d r a B e c k e r or walls, a narrowing of the aorta, the reversal of major arteries, underdevelopment of entire sections of the heart—the list goes on. Because the condition is characterized by an inherent failure of development, it is often a significant health concern. According to the Centers for Disease Control and Prevention (CDC), CHD affects nearly one percent, or about 40,000 births each year in the United States. It is the most common type of birth defect and approximately 25 percent of babies born with CHD will have a critical form, meaning they will need either surgery or some other form of treatment within the first year of their lives. Options range from monitoring and medication to catheter-based interventions, open-heart surgery and, in the most severe cases, transplantation—all of which are offered in the Texas Medical Center between the two primary pediatric heart institutions: Texas Children's Heart Center at Texas Children's Hospital and the Children's Heart Program at Children's Memorial Hermann Hospital. Currently ranked No. 2 in the nation for pedi- atric heart care and heart surgery by U.S. News & World Report and the only hospital in Texas to be named an Accredited Pediatric Heart Failure Institute, Texas Children's has been at the forefront of pediatric heart care since the begin- ning, and, in fact, was largely responsible for the formation of the field itself. A perfect union between some of the top pediatric specialists in the country at a time when the cardiopulmo- nary bypass machine made open heart surgery possible laid the foundation for Texas Children's to perform many of the earliest, most successful lifesaving procedures over five decades ago. Left: William Douglas, M.D., a pediatric cardiothoracic surgeon affiliated with Children's Memorial Hermann Hospital, performs surgery on a young baby born with a congenital heart defect. YO U N G at H E A R T HOW THE PEDIATRIC HEART PROGRAMS IN THE TEXAS MEDICAL CENTER ARE CARING FOR THE CHILDREN OF TODAY AND ADULTS OF TOMORROW l i v ing in to a du lt hood. As treatment options for CHDs have improved, more and more infants with CHD are

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