University of Virginia Health System

U.VA. PEDIATRIC HEART SURGEON PERFORMS LIFE-SAVING HEART SURGERY FOR FIRST TIME IN VIRGINIA

Just in time for the holidays, three-week-old Jonathan Sloan was released from the University of Virginia Health System after receiving a life-saving procedure for his congenital heart defect. Sloan was diagnosed with a rare and fatal condition called hypoplastic left heart syndrome shortly after his birth. The condition prevents the heart's left ventricle and aorta from growing large enough to pump blood to the rest of the body.

Until recently, the only two available treatments for this condition have been heart transplantation and an operation called the Norwood Procedure, which only prolongs survival in just over half the babies who receive it. For the first time in Virginia, a modified version of the Norwood Procedure was performed to save Sloan's life two weeks ago.

With the modified version of this procedure, the mortality rate is proving to be lower and the early outcomes are better when compared to the traditional Norwood Procedure, said Dr. Benjamin Peeler, pediatric heart surgeon at U.Va. Health System. Babies have been much more stable after the Modified Norwood Procedure and there is hope that it could allow better brain development as the baby grows during the first critical months of life.

The Norwood procedure has three goals: to get the right heart ventricle to provide permanent circulation to the body, to make the aorta large, and to create a shunt that provides blood flow to the lungs. This typically involves rebuilding an aorta to connect to the right ventricle and using a shunt to allow blood flow to the lungs.

Under the modified Norwood Procedure, the right ventricle is instead directly connected to a pulmonary artery conduit that creates circulation to the lungs. By this means, the baby's blood pressure is higher and there is better heart function. Blood oxygen levels are allowed to be higher after the modified Norwood Procedure and this will hopefully benefit infants as they grow.

Children who survive the Norwood procedure must undergo two more operations by the time they are about three years old. Survivors are expected to grow into adults and lead active lives. While people with hypoplastic left heart syndrome have some diminished physical capacity, they are usually able to handle ordinary physical demands.

Jonathan may not win the New York City marathon but he will be able to play on a soccer or baseball field, said Dr. William Hammill, medical director of the Virginia Children's Heart Center.

For now however, the Sloan family is happy to be able to bring their son home for Thanksgiving.

November 22, 2002