Cardiology & Heart Surgery

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Complex Case Spotlight

Novel Strategy Stabilizes Newborn’s Cardiomyopathy Prior to Heart Transplant

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Developing Fetus Diagnosed with Dilated Cardiomyopathy

After diagnostic scans at 27 weeks of a woman’s pregnancy revealed a weakened left ventricle in her fetus, maternal–fetal medicine and pediatric cardiology specialists at NYU Langone confirmed the diagnosis of dilated cardiomyopathy. The woman gave birth to a baby boy at 37 weeks, and he began receiving specialty care in the Congenital Cardiovascular Care Unit at Hassenfeld Children’s Hospital.

A fetal echocardiogram revealing the dilated cardiomyopathy.
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Intravenous Medication Retains PDA

As one part of a novel hybrid strategy to support the newborn’s severely weakened left ventricle, surgeons used prostaglandin E1 to keep the patent ductus arteriosus (PDA) in his healthy right ventricle open. Retaining the function of this PDA blood vessel, which normally closes after birth, helped augment blood flow throughout the baby’s body until a donor heart became available.

In infants, the patent ductus arteriosus in the right ventricle normally closes after birth, but can be kept open with medication.
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Pulmonary Artery Banding Limits Blood Flow

In the second part of the novel hybrid strategy to support the newborn’s severely weakened left ventricle, surgeons performed pulmonary artery banding. Placing bands on the outside of the pulmonary artery limited its blood flow from the heart to the lungs, thereby reducing the young patient’s risk of long-term lung damage.

Pulmonary artery banding, in the context of cardiomyopathy, can limit blood flow to the lungs and reduce long-term risks.
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Successful Heart Transplant

In June 2023, a donor heart became available and a team of doctors, including T.K. Susheel Kumar, MD, and Ralph S. Mosca, MD, performed a heart transplant after rebuilding the baby’s pulmonary arteries. The patient was able to leave the hospital two months later, and continued to receive outpatient rehabilitation services. In December 2023, he celebrated his first birthday.

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Photo of the pediatric cardiology care team. From left: Dr. Achiau Ludomirsky, Dr. Rakesh Singh, Henya Grossman, Nathaniel Grossman, Yair Broyer, Dr. Ralph S. Mosca, Dr. T.K. Susheel Kumar, and Dr. Manu Varma.
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