Small Devices for Small Patients

One in every 100 newborns has a heart problem. For decades these babies were treated with the same devices used in adults. But now there's a new standard of care, smaller tools to save the smallest of patients.

Little Vivian Andorf had her first heart surgery when she was just two hours old.

“She's missing one chamber of her heart,” says Vivian’s mother Margaret Androf. “Veins going from her lungs to her heart they are progressively narrow."

So far, Vivian's had seven surgeries and six cauterizations.

"I've seen the catheters and they're just these big long tubes and you just can't imagine how they get in," says Margaret.

"Most of the equipment that we use was designed and developed and produced for adults," says Dr. Alex Golden, MD, a Pediatric Cardiologist at the Cleveland Clinic Children's Hospital.

Imagine a wire the size of the cord on your headphones, snaking through a tiny baby.

"We gain more info about how the last surgery went and how the next surgery should go," explains Dr. Golden.

Using adult-sized catheters, doctors can damage access vessels in the groin and cause a blockage.

Doctor Alex Golden is the first pediatric cardiologist in the U.S. to use a new approved catheters for kids.

"Having a catheter that is 20 percent smaller than the smallest one we were using previously, I think, that's a great benefit," says Dr. Golden.

"It feels like we have so much hope," says Margaret.

Hope that a newborn given just a five percent chance of survival will beat the odds.

Vivian has one more surgery planned for this year. The new catheter is the first in the U.S. to be approved specifically for children.


TOPIC: Small Devices for Small Patients
REPORT: MB #3660

BACKGROUND: Heart problems that occur in infants are typically the result of a congenital heart defect that causes defective heart growth at some point during fetal development. In the United States, more than 35,000 infants are born with some kind of congenital heart defect. These defects start to develop sometime between the sixth and twelfth weeks of development which is when the heart is formed. The most common heart problems seen in infants are septal defects, which are holes in the heart. Infants can also be born with hypoplastic left heart syndrome where heart structures are not fully developed on the left side. Infants with these heart problems often have too much blood in the lungs and not enough blood in the body, leading to fatigue, poor nutrition and development, and breathing difficulties. If the heart problem is severe, it can cause permanent lung and organ damage and be life-threatening for the infant. (Source:

CAUSES: The cause of congenital heart defects is not always known, but certain factors can raise an infant's risk of heart problems. Since the heart forms within the first three months of fetal development, women may not realize they are pregnant and unknowingly expose the developing fetus to bacteria or viruses that can cause the heart to grow abnormally. In particular chickenpox, group B strep, listeria, toxoplasmosis, and certain vaccinations have been associated with congenital heart defects. Women with diabetes are also more likely to have an infant with heart abnormalities if they do not effectively monitor and control their disease. (Source:

MEDICAL BREAKTHROUGH: Cardiac catheterization of infants and children is a highly specialized procedure, which is performed in selected circumstances for additional diagnostic information. In addition, an increasing number of cardiac catheterization procedures are therapeutic and permanently correct or improve the underlying congenital heart condition, avoiding the need for open-chest surgery. Electrophysiologic catheterization procedures allow detailed investigation of heart rhythm abnormalities, and ablation procedures cure certain abnormal heart rhythms. (SOURCE:


Elizabeth Dunlop
Media Relations Associate
Corporate Communications Cleveland Clinic
(216) 445-1991

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