New Program to Help Heal Babies’ Hearts

Bradley Allen, M.D.

It’s been estimated that 35,000-40,000 children will be born in this country with heart defects. Many of these children will require surgical intervention.

Pediatric cardiology surgeons face special challenges with their young patients – consider:

An adult’s heart is the size of an adult’s fist, while an infant’s heart is only the size of an infant’s fist.
Adults with heart problems normally present a narrow range of acquired diseases, and aneurysms can develop. Babies, on the other hand, can present a wide range – some experts estimate as many as 50 variations – of heart-related problems.

Bradley Allen, M.D., has joined The University of Texas Medical School at Houston as a professor in the Division of Cardiothoracic Vascular Surgery to establish and direct a pediatric cardiology surgery center, in collaboration with Memorial Hermann Children’s Hospital.

“I’ve spent 20 years investigating how to protect the heart – and in particular the child’s heart,” Allen said.

In the process of repairing the heart during open heart surgery, he said, there are both oxygen-focused and blood-focused injuries. “Any time you do open heart surgery,”Allen said, “you are inevitably, at some time, stopping both processes.” As a consequence, both ischemic injury, or blood deprivation, and reperfusion injury, or injury during the process of returning blood to the organs, occurs. Another common problem occurring in most babies undergoing operative repairs is a reduction in oxygen, leading to hypoxia or cyanosis, a physiologic stressor impacting infants’ organs during cardiopulmonary bypass.

Allen has done extensive research on lessening injury in babies during surgical heart procedures. “I have found that by regulating the amount of oxygen given back to the baby, for instance, you can reduce injury,” he said.

Cardiothoracic surgeon Bradley Allen, M.D., met his wife, Charlie's Angels actress Jaclyn Smith, when he was a member of the surgical team operating on her father, who needed a mitral valve repair and a bypass. Allen said his wife likes to stand outside the pediatric intensive care unit and falls in love with the babies.

Cardiothoracic surgeon Bradley Allen, M.D., met his wife, “Charlie’s Angels” actress Jaclyn Smith, when he was a member of the surgical team operating on her father, who needed a mitral valve repair and a bypass. Allen said his wife likes to stand outside the pediatric intensive care unit and “falls in love with the babies.”

He is collaborating with Gerald Buckberg, M.D., his long-time mentor and colleague from the University of California at Los Angeles Medical Center, on a four-year $1million grant from the National Institutes of Health, “Controlled Reperfusion for Whole Body Ischemic Injury.”

The researcher said that the good news in his field is that congenital problems in newborns are being picked up much more quickly, especially through devices such as fetal echocardiograms. Trained neonatologists and pediatricians are diagnosing murmurs more rapidly in newborns, as well.

It takes a very large team to do pediatric cardiology surgery, the surgeon said, and he is in the process of recruiting personnel. Allen hopes to do at least 150 surgeries in the first year of the program, and 200 to 300 by the end of the third year. When he was the attending surgeon at the Heart Institute for Children, Hope Children’s Hospital in Oak Lawn, Ill., his team performed 550-600 surgeries a year.

The program Allen is establishing, he said, will help Houston and the pediatric cardiology surgery mission in Houston overall. Houston is the nation’s fourth largest city but has had only one pediatric heart program – at Texas Children’s Hospital.

Denver has more than one pediatric cardiology surgery center. LA has three to four of these centers; Chicago has four; Cleveland has three; New York City has several, Allen said. “With choice comes quicker access.”

His goals are two-fold: for the program to be among the top 20 centers in the nation, and to set up a yearly reunion for the children on whom the team has performed surgery, “a kind of picnic for them.We had that kind of program in Chicago and it worked well.”

Allen said that at these types of events, “the kids are running around with their siblings, and you can’t tell who has had the surgery and who hasn’t. That’s a great feeling – to see them healthy and happy.”

— By Colleen O’Brien, Medical School