Healing Hearts Smaller Than a Pea

From The Edmonton Journal comes the story of Dr. Lisa Hornberger, a renowned fetal cardiologist recruited last fall by Alberta Health Services and the University of Alberta from San Fransisco:

Before Hornberger arrived, pediatric cardiologists, who specialize in children rather than fetuses, were finding heart abnormalities in utero, but didn’t have the skills or knowledge to do procedures on those babies before they were born.

Hornberger, who has worked on fetal hearts since 1987 and wrote the first textbook in the field, has helped in fetal operations in San Francisco, where needles are poked through a woman’s pregnant belly to the fetus. Tiny balloons are sent down that needle to unplug valves in the baby’s heart in similar fashion to angioplasty in adults, where blocked arteries are opened.

“If we don’t do something, we lose those babies either before or after birth, so dilating their valves will potentially give them a chance,” she said. Only about 80 to 90 such cases have been performed in the world, but Hornberger plans to bring them to Edmonton.

Hornberger is also pushing boundaries to screen babies in the womb with echocardiograms at earlier stages to increase detection of heart abnormalities, prepare for possible interventions and help moms plan their futures.

“It’s pretty amazing,” Hornberger said, describing how a 10-week-old fetus is about two centimeters from buttocks to head and has a heart about one-quarter the size of a pencil eraser. Normally, echocardiograms are done on fetuses 18 weeks or older. Hornberger is one of the few doctors in North America starting to do echocardiograms when the fetus is six to 10 weeks old, looking for rhythm dysfunction and abnormalities that put the baby at risk for developing fetal heart disease in the pregnancy.