Portland, Ore.

Doernbecher is only hospital in Oregon to offer pinhole procedure for atrial septal defect

Seven-year-old Robert Maricelli of Sherwood was born with a half-inch hole between the two upper chambers of his heart. Instead of undergoing an invasive open-heart surgery, he was able to get the gap closed at Oregon Health & Science University Doernbecher Children's Hospital through a pinhole-sized incision. Robert had the procedure July 23 and went home the next day, unlike an open-heart procedure that would have kept him in the hospital for up to five days. One out of every 1,000 children are born with this congenital heart defect, called atrial septal defect, and it is the most common heart defect diagnosed in adults.

"Afterwards he felt great. He's been out running and playing with his little brother instead of spending months recovering," said Wendy Maricelli, Robert's mom. "We were very happy we didn't have to go through the more traumatic (open-heart) surgery. Knowing his chest would've been opened and his heart stopped would've been too much for us."

Doernbecher interventional cardiologist Grant Burch, M.D., is the only physician in Oregon trained to insert a new Federal Drug Administration-approved device into patient's hearts. The mushroom-looking wire mesh device, made of nickel and titanium, is called the AMPLATZER occlusion device.

Burch inserts the device through a tiny catheter in one of a patient's larger veins, such as the femoral vein in the groin. The catheter travels through the body to the hole in the patient's heart. Burch then opens the device, covering and sealing both sides of the hole. Once opened, it looks similar to two mushroom caps connected at the stems.

"It's rewarding to save these patients from an open-heart surgery that would be more invasive and require the need for a heart-lung bypass machine," said Burch, also an assistant professor of pediatrics (pediatric cardiology) in the OHSU School of Medicine. "We put in about a dozen of these devices in the last four months and all have worked beautifully with no problems." Burch has inserted them in children and adults.

Robert's heart condition was detected when he was just 3 months old, thanks to an astute pediatrician who heard an abnormal heart murmur. An echocardiogram confirmed the hole. Young children like Robert don't usually exhibit symptoms of the defect. The defect allows blood to recirculate through the lungs unnecessarily, making the heart overwork. As children mature into adulthood, they can experience symptoms such as shortness of breath and fatigue. Later in life, if untreated, the condition can lead to an abnormal heart rhythm (arrhythmia), congestive heart failure, pulmonary hypertension and, in some cases, death.

More information about the device can be found on the AMPLATZER Web site at www.amplatzer.com.

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