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Innovative Miniature Heart-Lung Machine for Infants

Cardiopulmonary Bypass System for Pediatric Cardiac Surgery
  • An innovative miniature heart-lung machine, placed close to a patient being operated during surgery to repair congenital heart defects, helps eliminate the need for blood transfusions.
  • Khanh H. Nguyen, MD, former Chief of Pediatric Cardiac Surgery at Maria Fareri Children’s Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), has been instrumental in developing this unprecedented system, which manages heart and lung functions during heart surgery.
  • This system decreases the need to prime blood with saline, which typically is a requirement of traditional open-heart surgery, as it flows through the bypass system’s tubes. That means that the child’s blood isn’t diluted as much. This new system also avoids decreasing the red blood cell count, a critical vital sign.    

The pediatric operative mortality of pediatric cardiac surgery at Westchester Medical Center is among the best 5% of the programs in the Society of Thoracic Surgeons database.

Reducing or Even Eliminating the Need for Blood Transfusion

This study, published in The Annals of Thoracic Surgery, details how an innovative miniature heart-lung machine, strategically placed on an Operating Room surgical table close to a patient, enhances infant health during surgery to repair congenital heart defects.

Khanh H. Nguyen, MD, former Chief of Pediatric Cardiac Surgery at Maria Fareri Children’s Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), has been instrumental in developing this unprecedented cardiopulmonary-bypass system. It is one of several transformative techniques optimized during pediatric cardiac surgery by Dr. Nguyen and Maria Fareri Children’s Hospital’s highly skilled and experienced team. For appointments or referrals, please call 914.493.8793.

Heart-lung machines manage functions of the heart and lungs during cardiac surgery, maintaining blood flow and oxygen level. While a conventional heart-lung machine and its pediatric version are positioned on a wheeled console, the surgeon uses a miniaturized system mounted on the operating table. Its proximity to the patient’s heart decreases the need to place blood in the bypass system’s tubes. Less circulating volume results in less dilution of infants’ small volume of blood. In addition, dilution decreases the red-blood cell count, a critical parameter. As such, the miniaturized heart-lung machine helps reduce and even eliminate the requirement for blood transfusion. Its small circuit also minimizes systemic inflammation that manifests as general swelling and fluid accumulation, side effects of an open-heart operation. That facilitates a quicker return to normal breathing and organ function. The reduction or avoidance of using donated blood also reduces well-known potential complications of blood transfusion. Initial clinical data have shown that the miniature heart-lung system is safe, reliable and reproducible.

A Significant Advance in Pediatric Cardiac Surgery

Overall, this revolutionary approach significantly advances pediatric cardiac surgery. It improves overall outcomes and is an essential tool to facilitate bloodless surgery in very small infants. As prenatal diagnosis of congenital heart disease has become common practice, operations now can be planned even before the child is born. The Maria Fareri Children’s Hospital pediatric cardiac surgery team is poised to use this miniaturized bypass machine for those newborns, and if necessary, use the child’s own cord blood to prepare the machine’s circuit. This approach can potentially complete the entire surgical treatment of the baby’s heart condition without use of donated blood.

The Annals of Thoracic Surgery is a medical journal covering pulmonary diseases and surgery. It is the official journal of the Society of Thoracic Surgeons and the Southern Thoracic Surgical Association. This study was published in September 2018.

Read the full study.

Patient Stories

Orianna Beauvais

Orianna was diagnosed in utero with a congenital heart defect. Her mom, Becky, and dad, James, of Pearl River, consulted with surgeons who wanted to perform open-heart surgery. Then, they met with Khanh H. Nguyen, MD, Chief of Pediatric Cardiac Surgery. “He explained how the procedure would be done and what benefits this approach offers,” recalls Becky. “We felt very comfortable.” Following her surgery, in February 2018, Orianna’s parents marveled at her quick recovery.

“Before her surgery, we had to put food in front of her, and she wasn’t gaining weight,” Becky explains. “The day after we went home from the hospital, she was a vibrant little girl, like nothing had happened. She’s full of energy, and when she’s hungry, she grabs a snack.”

Bryce Kelly

When Bryce was born on November 13, 2017, a heart murmur raised red flags. An electrocardiogram revealed a hole in her heart. Her parents, Erin and Mike of Beacon, took her to a cardiologist every two weeks.

On March 20, 2018, after Bryce reached 10 pounds, Dr. Nguyen performed surgery. “We were in total shock and a little scared,” says Erin. “She was very thin; her hands and feet were always cold; you could feel her heart beating very fast. She slept a lot after feedings because her body was working so hard to stay alive.”

Bryce came home two days after surgery with a small incision under her arm. “Now, she’s a totally different baby,” says Erin. “Her cheeks, arms and legs are chubby. It’s amazing.”

Robert Roseboro

Robert, a Yonkers teen, was born prematurely with a hole in his heart. Yet, for years, he never had serious symptoms. Then, he felt tired and his “heart hurt,” even when he wasn’t running. Dr. Nguyen determined his heart was enlarged and that a faulty valve was impeding its ability to function. Robert’s parents, Hazel and Robert, were concerned because Robert Sr.’s own recovery from open-heart surgery as an adult had taken four months.

Dr. Nguyen performed surgery in February 2018. “We’re so pleased with the outcome,” says Hazel. “Robert finished eighth grade and went on vacation to a Disney World water park.

He has a wicked sense of humor, plays basketball and is exceptionally kind and caring. His teachers think he’s very bright, and he’s active in his church youth group. Seeing him smile, laugh and connect with people again has been tremendous.”