Cardiac surgery is reducing the use of plastic — starting with an operation for newborns who have life-threatening heart disease generally called single ventricle.
Single ventricle is so dangerous because it means only one of the heart’s two ventricles can adequately pump blood. Typically, affected infants undergo open-heart surgery to receive a Blalock shunt, which is a skinny tube made of PTFE — a synthetic polymer — that re-routes their blood flow to the lungs so enough oxygenated blood can get to their bodies. But when blood is exposed to foreign material, such as a plastic shunt, clots can form very easily.
This fall, a clinical trial at Boston Children’s Hospital will use patients’ own umbilical veins to create the shunt instead of plastic tubing.
Clots in Blalock shunts pose a serious threat. “All of the blood flow to the lungs is dependent on that shunt staying open,” says Sitaram Emani, MD, who is leading the trial along with his colleague David Hoganson, MD.
If there is a clot, the blood oxygen level can drop so low that the infant needs emergency surgery to survive. “We now know clots occur more often than we thought — up to 20 percent of newborns have some form of clotting,” says Emani. “That’s why we’re so meticulous about using blood thinners.”
But blood thinners have a downside: increased bleeding.
“We’re essentially poisoning the whole system with anti-clotting agents,” Emani explains, “and preventing blood from clotting blood in places where it’s supposed to clot.”
Read the full post on Vector: Using newborns’ own umbilical cords as shunts for heart surgery
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