Second bionic ear gives depth to sound Sarah Novick, 5, of Windham, Maine, is one of just a few children in the world with two cochlear implants, a device that can bring a world of sound to people who are born deaf. The sound-capturing device, which is surgically implanted behind a patient's ear, uses an electrical lead to stimulate the auditory nerve, mimicking the body's own sensory mechanism. Doctors and family hope that Sarah, who got her first cochlear implant four years ago, will now hear the world more naturally. The device should allow her to make sense out of noisy environments such as her mainstream classroom, and distinguish where individual sounds are coming from. As the first Children's patient with two implants, Sarah's story will be of much interest to future patient families facing deafness. –CM

Fixing a tiny heart

Children's cardiologists and surgeons have been pioneering increasingly complex heart procedures since performing the first repair of a cardiac defect 65 years ago. But in the last two years they've taken their work to a new level, and today they can correct some deadly heart conditions before a child ever leaves the womb. In 2001, Children's specialists teamed with other doctors to open the tiny, blocked aorta of a 23-week fetus who would have developed a life-threatening heart problem called hypoplastic left heart syndrome (HLHS), a congenital defect where the left ventricle (which pumps oxygenated blood to the body) fails to develop. It was the first such procedure in the world, but last fall they faced an even more complex case.

Pam and Chris Pomrink came from Pennsylvania to get treatment for their unborn son's heart condition.

Pam and Chris Pomrink of Bethlehem, Penn., learned that their unborn child not only had HLHS, but also lacked a second defect that should have helped his heart route oxygenated blood to the body. Without a hole in the atrial wall known as an ASD (atrial septal defect), which allows blood to cross to the right side of the heart to be pumped to the body, the baby's chances of survival were below 40 percent.

The Pomrinks turned to the Web and learned that Children's had successfully treated a child without an ASD. Despite the extensive experience of the hospital's cardiologists, the Pomrink's unborn baby's HLHS was too advanced for them to fix in utero. So doctors embarked upon another world-first, creating an ASD before the child was born.

Guided by ultrasound, doctors directed a needle into Pam's abdomen, through her uterus, and gently into the baby's heart. Cardiologist-in-Chief Jim Lock, MD, created a small perforation in the atrium and widened it to the proper size with a tiny balloon catheter. The success was visible immediately, as the new blood flow showed up on the baby's echocardiogram.

Jake Pomrink was born Nov. 5, and two days later underwent the first of the three surgeries to repair his HLHS. Because of his fetal procedure, he survived and went into surgery a stronger, healthier baby. –CM

Vision of the future

The lens is inserted through an incision and unfolded to its full size.

Small incisions are made at the edge of the eye's outer lining, or cornea, providing access to the anterior chamber.

Cataracts are often considered an adult problem, but the condition affects one in 2,000 children as well. In kids, early intervention is the key to preventing blindness and preserving cognitive development.

After pediatric cataracts are removed, artificial lenses are so crucial to a child's recovery that they are typically implanted surgically. But this procedure is widely avoided in children under 6 because of the challenges it poses. However, led by David Hunter, MD, PhD, chair of Ophthalmology, Children's experts are using advanced surgical techniques to implant lenses and save the vision of patients as young as 6 months old.

Children's ophthalmologists use special software in the operating room to predict a child's eye growth in future years. That way they can choose the best possible lens so that it may never have to be replaced even when the eye grows.–CM