Heart Center Research and Innovation

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physicianFor more than 50 years, Boston Children’s cardiac specialists and investigators have played a vital role in the field of cardiac research, pioneering treatment approaches and major advances in the care and treatment of children with congenital and acquired heart defects. This work continues today as we regularly participate in cardiac clinical trials.

Our innovative approach

Innovations play a critical role in our patient’s health, so our Heart Center team is constantly creating new ways to improve care. Some are rooted in scientific research done in labs. Other improvements arise from moments spent at the bedside, when doctors and nurses see opportunities to improve current treatment methods. 

An innovation may be “small,” like finding a creative way to help a young patient take her medication on time. Or it may be a big discovery that changes the entire field of pediatric heart care.

Innovation in action

Here are some examples of our innovations that have helped us improve the survival rate and quality of life of children born with heart defects.

Our history 

physician and childThe Heart Center at Boston Children's Hospital was founded in 1950 by Alexander S. Nadas, MD, and has grown to become the largest and one of the most respected pediatric cardiovascular programs in the world, with a history of cardiac care innovations.

2009: Institution of the Congenital Heart Valve Program, devoted to developing better ways of treating malfunctioning heart valves.    

2008: Institution of Standardized Clinical Patient and Management Plans (SCAMP), a novel approach for developing better strategies for patient care.

2007: Institution of 24-hour in-house cardiac intensivist faculty coverage for the Cardiac Intensive Care Unit.

2004: Institution of the Crisis Resource Management Program is established to train practitioners using cardiac simulation techniques.

2003: Since the inception of the Heart Transplant Program in 1986, Boston Children's cardiac surgeons have performed more than 150 heart transplants, making it one of the largest pediatric heart transplant programs in the country.

2003: Boston Children's continues to perform fetal interventions to treat congenital heart defects. Since the hospital's first attempt in March 2000, the Heart Center's Fetal Program has performed 15 fetal interventions, including 11 aortic valve balloon dilations, creation of three atrial septal defects and one pulmonary valve dilation.

2002: The first-ever successful in utero repair of a heart defect in a fetus is performed, resulting in the birth of a healthy baby.

2002: Boston Children's is the first pediatric center to obtain a surgical robotic system. The first procedures were performed in March 2002; since then the Department of Cardiac Surgery has carried out many robotic-assisted operations.

2002: Boston Children's is the first to perform robot-assisted surgery to correct a Patent Ductus Arteriosus (PDA), a blood vessel present in fetal life that does not close properly, resulting in excess blood to the lungs.

2002: Laboratory Medicine investigator Nader Rifai, MD, co-authors a landmark study likely to alter federal guidelines for cardiovascular disease detection, showing that a simple and inexpensive blood test for C-reactive protein (CRP)—a substance produced in the liver when arteries become inflamed—is a more powerful predictor of a person's risk of suffering a heart attack or stroke than screening based on LDL cholesterol.

2002: HHMI investigator Mark Keating, MD, shows for the first time that zebrafish can regenerate heart muscle within two months after a severe injury. His team also identifies a possible genetic and molecular model for regeneration in zebrafish which could help direct further research that would benefit millions of people who suffer heart attacks or experience other forms of cardiac injury.

2001: Boston Children's clinicians care for a hemophiliac patient with life-threatening heart disease, making him the world's first hemophiliac to be placed on extracorporeal membrane oxygenation (ECMO), and only the second to undergo a heart transplant.

2001: Boston Children's performs the world's first successful in utero treatment of hypoplastic left heart syndrome (HLHS) in a 19-week-old fetus, threading a cardiac catheter through the fetus's atrial valve and inflating a balloon to widen the opening.

2000: Boston Children's Heart Center performs its 100th heart transplant.

1999: Thomas Jaksic, MD, introduces new laboratory techniques to analyze nutritional and energy requirements of the critically ill neonate, even those on life support and ECMO. These techniques have significant likelihood of influencing care for very sick neonates.

1999: The FDA approves the use of the CardioSEAL, a minimally invasive device developed at Boston Children's to repair holes in the hearts of the most seriously ill heart patients. The device is implanted with a cardiac catheter.

1999: Simon Hoerstrup, MD, grows replacement heart valves from the cells of sheep, an advance expected to lead to more durable valves than the mechanical and animal valves used today.

1996: Kathy Jenkins, MD, and James Lock, MD, develop the Webster-Jenkins basket catheter to provide rapid diagnostic information in mapping multiple sites of cardiac arrhythmias.

1990: Radio waves directed through a catheter correct a cardiac rhythm disorder called Wolff-Parkinson-White syndrome, marking the first pediatric non-surgical repair of a cardiac arrhythmia.

1980: First “Norwood” repair of hypoplastic left heart syndrome by William Norwood, MD.

1972: First routine intracardiac palliation of complex congenital heart disease in infants by Aldo Castaneda, MD.

1938: Robert Gross, MD, performs the first successful surgical procedure to correct a congenital heart defect in a baby.

Boston Children's is one of the top pediatric research centers in the world. Our cardiovascular research program includes laboratory scientists and clinical researchers who investigate heart conditions from every angle – from examining cells under the microscope to tracking response to current drug regimens – so we can create better treatments for your child.

Research

All senior medical staff members of the Boston Children's Heart Center participate in clinical research activities, and many do laboratory research as well.

Current projects include: 

  • the further development of innovative catheterization treatments for the treatment of complex cardiac diseases
  • the use of transcatheter radio-frequency ablation to treat both simple and complex arrhythmias
  • a six-center study of HIV's effect on the hearts of infants and children
  • a study of the effects of a drug (Adriamycin) on heart function is survivors of childhood cancer
  • a cross-sectional study on long-term outcome after the Fontan procedure
  • population-based studies of clinical outcomes and resource utilization for congenital heart defects
  • improved approaches to protecting the heart and brain in infants and children during surgical procedures
  • the design and creation of heart valves using a patient's own tissue
  • the design and evaluation of new therapeutic catheters and techniques
  • the design and evaluation of three-dimensional electrophysiological mapping techniques
  • control of the body's inflammatory response to cardiopulmonary bypass and surgery
  • evaluation of the biophysics of radio-frequency ablation to treat arrhythmia

Cardiac Surgery research

Our Cardiac Surgery Research Laboratory houses a multidisciplinary team of investigators involved in basic and applied research who study mechanisms of heart disease and new treatments for children with congenital heart defects.

The principal areas of active research are:

  • Surgical robotics and ultrasound-guided intracardiac surgery. The department is pioneering the use of 3-D ultrasound and laparoscopic techniques to operate on the beating heart.
  • Myocardial metabolism and myocardial hypertrophy and heart failure. Researchers are exploring new methods of myocardial preservation during heart surgery and the role of angiogenic growth factors in heart failure.
  • Tissue engineering to stimulate the growth of new tissue to repair congenital defects, including valve abnormalities, right ventricular defects and arrhythmias.

The division also is developing a fetal cardiac surgery laboratory that will be conducting several clinical research projects including those to: 

  • evaluate techniques to remodel the right ventricle after repair of Tetralogy of Fallot
  • determine optimal hematocrit levels to prevent neurologic injury during cardiopulmonary bypass
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The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO
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