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Saving an Infant’s Heart with A Balloon

The Kepler University Hospital in Linz provides life-saving procedures, even to unborn fetuses.

Peter Opelt

The ingenious method to treat serious heart defects takes just a few minutes. Doctors in Linz can change the start of many infants’ lives while the infant is still in utero. Thanks to a partnership between pediatric cardiology and prenatal medicine at Linz's Kepler University Hospital, aortic or pulmonary valve stenosis can be corrected while the baby is still in utero. Normally, the blood flow opens and closes these heart valves however, if the valves fail to work properly pressure builds up in the heart, resulting in the ventricle expanding and subsequently shrinking again. The heart muscle tissue becomes scar tissue and after birth, the damaged ventricle may require several hours of surgery in order for the fetus to survive.

The Surgery can be Performed in Just a Few Minutes
Should a patient’s gynecologist discover an abnormality during a routine ultrasound examination, the pregnant woman can be referred to see a specialist at the Kepler University Hospital to undergo an ultrasound for diagnosis. The specialist will assess whether or not there is a congenital heart defect and if the fetus will have to undergo cardiac catheterization. The life-saving procedure takes only ten minutes. Dr. Iris Scharnreitner, a senior physician at Kepler University Hospital, remarked: "This takes teamwork." Her part in the procedure includes using a hollow needle to penetrate through the mother's abdomen, just outside of the fetus's defective heart valve.

Pediatric cardiologists insert a balloon-tipped catheter through the hollow needle and then inflate the balloon to blow the heart valve open and allow blood to circulate. The head of the fetomaternal area added: "The sooner we can diagnose the condition, the better our chances of success are." As the fetus continues to grow in utero, the heart valve may function normally up until delivery. Despite a successful in utero procedure, often times some children may require surgery afterwards, surgery that may involve replacing these heart valves. At the earliest, surgery can be performed during the 21st of pregnancy and at the latest, during the 32nd week of pregnancy. The Kepler University Hospital is the largest center of its kind, performing this heart valve procedure on around 20 small patients from all over Europe.

The procedure requires a considerable amount of experience and expertise. Scharnreitner added: "We have to assess just which infants will respond well to the operation as preparing for the procedure should not to be taken lightly. The fetus has to be in just the right position." Her boss, Univ. Prof. Peter Oppelt, stated: "In order for the procedure to be successful, experts in various disciplines have to collaborate together; the individual alone will not be successful." Peter Oppelt, also a professor at the JKU’s Faculty of Medicine, says it is important that his employees work independently in line with their skills and expertise. The expert added: "We believe in team spirit and a sense of camaraderie is important to us."