How to Mend a Broken Heart

A newborn’s heart is about the size of its fist, the valves inside minuscule. This presents an issue for surgeons trying to help infants born with heart defects. Traditional mechanical replacement valves are larger than a newborn’s, so they may compress the coronary artery or trigger problems in the heart’s electrical system. And surgical repair is tricky because many infants have too little valve tissue to stitch together. “No matter what we try, it just doesn’t work,” says Carl Backer (pictured at top), head of cardiovascular surgery at the Ann & Robert H. Lurie Children’s Hospital of Chicago. Now there’s a more viable option: In March, the Food and Drug Administration approved the world’s smallest mechanical heart valve. Backer, who took the 15-millimeter device manufactured by Abbott Laboratories through clinical trials, first implanted one of the dime-size valves in 2011 under a “compassionate use” exemption, which allows doctors access to devices still in the process of earning FDA approval. Since then, 70 percent of patients have survived at least a year—infants who might otherwise have died within days. “It’s a game-changer,” Backer says.

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