CHKD Blog

CHKD Dr. Michael Vance Checking Patient Zoe Irby's Heart

Healing the Tiniest of Hearts

Author: Elizabeth Simpson Earley
Published Date: Wednesday, February 05, 2020

Zoe Irby arrived early in this world, weighing 1 pound, 3 ounces, after only 24 weeks in the womb.

There was something else amiss.

Babies are born with an opening between two of the main arteries connected to the heart that usually closes on its own when they start to breathe after birth. But Zoe’s didn’t close. That meant extra blood was flowing to her lungs.

Her tiny lungs and blood vessels and heart had to work extra hard after she was born last June. She had to be on a ventilator, and struggled to gain weight.

The defect, called patent ductus arteriosus, is common among premature babies. Nearly 12,000 low weight babies are born in the United States each year with an opening in their heart large enough to require some kind of intervention.

Doctors told her mother, Cheyenne Irby of Virginia Beach, that they would first give Zoe medication they hoped would close the opening. That didn’t work. The most common second option was surgery, but neonatologists didn’t want to risk such an invasive procedure on a tiny, delicate baby.

But CHKD doctors had recently learned of another option that had only become available a few months earlier, something called the Amplatzer Piccolo Occluder, that was approved by the Food and Drug Administration in January of 2019.

The device is a miniaturized version of one that is used on bigger babies and inserted using a minimally invasive approach. Pictured: Piccolo is the smaller device shown next to a similar device used for larger babies. Piccolo Occluder Device

Dr. Michael Vance, a cardiologist at CHKD, was in the first batch of doctors from about a dozen pediatric centers across the country to be trained to use the procedure developed by healthcare company Abbott. A self-expanding wire mesh device is inserted through a cable into a small incision in the leg and guided through vessels to the heart, where it’s placed to seal the opening in the heart.

On July 18, Zoe was the first baby at CHKD to undergo the Piccolo treatment. Three days later, she was breathing so much better that she was taken off the ventilator. She gained weight. By September, she was discharged to go home, and continues to thrive.

Since then, four more babies at CHKD have had the same procedure, all with good results.

“It’s been a huge advantage for them,” Dr. Vance said. “They’re getting off of the ventilators, eating better, and getting out of the hospital sooner.

Cheyenne said Zoe is reaching her development milestones, and her pediatrician has been pleased with her progress. “It was scary at first to try something so new, but the procedure didn’t take long, and Zoe started doing so much better afterwards.”



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About Elizabeth Simpson Earley

Elizabeth Simpson Earley works in the marketing and public relations department at CHKD. She handles calls from the media, and helps to promote CHKD and children’s health. A former health reporter at The Virginian-Pilot, Elizabeth has two grown daughters who were treated at CHKD on a regular basis.

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