Childrens Heart Center

Transcript

• 00:05- There are at least
• 00:0640 or 50 different types of congenital heart disease.
• 00:09Some are very straightforward, some are very complex,
• 00:12and they all affect the structure of the heart
• 00:14and the physiology of the heart in different ways.
• 00:17- It can involve malformed chambers, tight or synodic vessels,
• 00:20or transposed arteries, and these defects alter the hemodynamics,
• 00:24often causing poor blood to circulate to the body or forcing the heart
• 00:29to pump at dangerously high pressures, which eventually lead
• 00:31to heart muscle fatigue or failure.
• 00:33- You know, baby needs to eat and grow and thrive,
• 00:38and that requires a normal amount of blood flow out to the body
• 00:42and that normal amount of oxygen in that blood, so that all of those
• 00:46developing processes can take place.
• 00:49So in very severe forms of congenital heart disease,
• 00:51the heart is just not capable of doing that
• 00:54and so we often will need to make modifications
• 00:57to augment the heart's ability to do what it needs to do.
• 01:05- Treating a child is more than just treating a heart.
• 01:08It involves obviously close collaboration between numerous specialists
• 01:12and caregivers to optimize what is the best plan
• 01:16and the best treatment for any child in their family.
• 01:20- In order to make those diagnoses,
• 01:24we have to really understand the anatomy
• 01:26with the way the heart works, what we call the physiology.
• 01:29- The type of imaging and advanced diagnostic techniques we have here
• 01:34allow us to understand precisely what we need to do.
• 01:37- We're lucky to have experts and specifically congenital heart imaging,
• 01:41to process them in ways that allow us to understand exactly what's going on.
• 01:46And these days, to even print models of the heart.
• 01:49So ahead of any intervention, we can look at the heart
• 01:53as a printed model and understand things in three dimensions.
• 01:57- Care of the congenital heart patient is a team sport.
• 01:59Although I do the operations along with the surgical team,
• 02:03I couldn't do that without an anesthesiologist and nursing team
• 02:07a cardiology team to do the diagnosis,
• 02:09a critical care team to take care of that patient afterwards.
• 02:13Specifically in the cath lab,
• 02:15more and more things are being done in a less invasive way,
• 02:19which is good for everybody.
• 02:20- We're now able to allow babies to avoid an operation,
• 02:25even in the very first few days and months of life,
• 02:29either not needing surgery at all because we're able to completely
• 02:33take care of the problem with a catheter based approach,
• 02:36or at least to delay the need for surgery.
• 02:40- Sometimes we can do a single operation or a single procedure
• 02:43and take care of something once,
• 02:45and they don't have any other interventions the rest of their lives.
• 02:49Other times it requires a series of operations
• 02:52and continued management through their entire life.
• 02:55- We offer the full spectrum of care, from cutting edge medical management
• 02:59to ventricular assist devices that act as a bridge to heart transplant.
• 03:02- We are the only program in the state of Connecticut right now
• 03:05that has an active children's heart transplant program.
• 03:08- We have a dedicated pediatric transplant infrastructure that manages everything from
• 03:12high acuity surgical periods
• 03:14to the lifelong immunosuppression management that's required after heart transplant.
• 03:18- One of the advantages to our center is that we are well integrated
• 03:24with our experts in adult congenital heart disease,
• 03:27who really we are able to hand off
• 03:31our young children to as they get older and reach adulthood.
• 03:34- In fact, now there are more adults with congenital heart disease
• 03:37because they've survived than children with congenital heart disease.
• 03:41And this gap will continue to increase over time.
• 03:49- Yale is a well known research institution,
• 03:53and we bring to bear that experience in the space of congenital heart disease.
• 04:00- This research includes new type devices that might be put in in the cath lab.
• 04:04They include new type of regenerative valve technology
• 04:07that we're developing to use in the operating room.
• 04:11It includes researching the genetics of congenital heart disease,
• 04:15which allow us to understand why congenital heart disease forms
• 04:18and understand the different
• 04:20classes of congenital heart disease and the different risk categories.
• 04:24- What can we anticipate for how their heart is going to function in the long term?
• 04:27How will it tolerate an operation?
• 04:29Is there an operation that might be better for this patient
• 04:32because of a particular problem with their genetics?
• 04:35- And we're also researching the outcomes based data
• 04:38to improve the long term quality of life for transplant recipients.
• 04:41So we're moving beyond simple survival
• 04:44to ensuring these children can lead active lives and full lives.
• 04:48- These are all areas
• 04:50that tap into the depth and breadth of expertise,
• 04:54both in cardiology but also outside of cardiology.
• 04:59Because of the institution that we're in.