Research & Innovation | Overview
Because of our team’s experience and expertise and the many resources available to us at the Benderson Family Heart Center, we believe we can constantly improve the diagnoses and treatment of congenital heart valve disease. Here are some of our recent initiatives to improve the care of our patients:
A new pulmonary valve replacement grows with child
We have created the first prosthetic pulmonary valve replacement that is specifically designed for pediatric patients and can expand over time inside a child’s anatomy. Known as the Autus Valve, it can be adjusted to match a patient’s heart anatomy before it is implanted. Once the device is implanted, a catheter balloon can expand the valve to align with a child’s growth.
A heart valve that grows along with a child could reduce invasive surgeries
A child can have a replacement pulmonary valve fitted to their body size and, if needed, adjusted for size through a minimally invasive transcatheter balloon dilation procedure.
Timely Cone repair improves tricuspid valve repair outcomes
We evaluated the patient records of more than 150 patients with Ebstein's anomaly who had a Cone procedure to repair diseased tricuspid valve. We found that the time to tricuspid valve reoperation may be shorter when Cone repair is performed before age four years, but this result requires confirmation in a larger sample. An annuloplasty ring should be considered when appropriate.
Partial heart transplant is a new aortic valve replacement option
We were one of the first hospitals in the world to perform a partial heart transplant as an alternative to a heart valve replacement procedure. We removed a 4-year-old boy’s diseased aortic valve and replaced it with a donor’s healthy valve, which is expected to grow along with the boy, Jack.
Eight years of preparation for a surgical first: a partial heart transplant
Our cardiac surgeons performed a partial heart transplant on 4-year-old Jack. It’s possibly the first such transplant as an elective procedure, and probably the first of many at Boston Children’s.
Finding an ideal method for tricuspid valve repair
Our recent study of more than 200 patients with hypoplastic left heart syndrome (HLHS) and significant tricuspid valve regurgitation showed they were more likely to have successful tricuspid valve repair if they had less tricuspid annular dilation, less-severe RV enlargement, and predominantly anterior leaflet prolapse. Successful tricuspid valve repair was associated with improved mid- and long-term outcomes.
Finding longer-lasting mitral valve patch materials
Working with the Cardiovascular 3D Modeling and Simulation Program, we are evaluating the short- and long-term effects of using different types of patch material to repair deficient mitral valves that require additional leaflet tissue to facilitate appropriate valve coaptation.
Study aims to lessen regurgitation
We’re also helping to develop a clinical trial for a device that may be beneficial in reducing the amount of regurgitation in patients with HLHS who have had a single-ventricle surgery (Norwood, bi-directional Glenn, or Fontan).
Consider referring a patient for one of our clinical trials
We have several ongoing studies, including a clinical trial for the Autus Valve, that would benefit from the participation of patients with congenital heart valve disease. For example, patients with tetralogy of Fallot often develop severe pulmonary regurgitation. Blood flows backward through the valve, causing an enlarged or “dilated” right ventricle. We have been working with companies to create a replacement pulmonary valve that can be placed without surgery in the catheter lab. Please reach out to Dr. Christopher Baird, director of the Congenital Heart Valve Program, about this and other heart valve clinical trials: chris.baird@cardio.chboston.org.
Published research
Here is a sample of published research that documents our efforts to better understand valve disease and how we can enhance care for patients:
Aortic valve disease
Simple leaflet repair
Publication: Aortic Valve Repair in the Pediatric Population: Midterm Outcomes Comparing Leaflet Repair Using Autologous Pericardium Versus Porcine Intestinal Submucosa (Cormatrix ®). The Journal of the American College of Cardiology. March 2017; Volume 69, Issue 11: Page 557. https://www.sciencedirect.com/science/article/pii/S0735109717339463?via%3Dihub
Complex leaflet repairs/bicuspidization
Publication: Symmetric Bicuspidizing Repair for Patients with Congenital Aortic or Truncal Valve Disease. The Journal of Thoracic Cardiovascular Surgery. Aug. 2023; Volume 166, Issue 22: Pages 283-291. https://www.jtcvs.org/article/S0022-5223(22)01131-X/abstract
Valve-sparing aortic root repair
Publication: Valve-sparing aortic root replacement and remodeling with complex aortic valve reconstruction in children and young adults with moderate or severe aortic regurgitation. The Journal of Thoracic Cardiovascular Surgery. June 2014; Volume 147, Issue 6: Pages 1768-1776. https://www.sciencedirect.com/science/article/pii/S0022522314002621?via%3Dihub
Ozaki procedure
Publication: Congenital Aortic and Truncal Valve Reconstruction Using the Ozaki Technique: Short-Term Clinical Results. The Journal of Thoracic and Cardiovascular Surgery. May 2021; Volume 161, Issue 5: Pages 1567-1577. https://www.jtcvs.org/article/S0022-5223(20)30438-4/fulltext
Bioprosthetic aortic valve replacement
Publication: Valve Replacement with an Expandable Bioprosthetic Valve in Neonates and Infants. Journal of the American College of Cardiology. March 2013; Volume 61, Issue 10: Supplement. https://www.jacc.org/doi/10.1016/S0735-1097%2813%2960426-X
Mechanical aortic valve replacement
Publication: Outcomes After Mechanical Aortic Valve Replacement in Patients with Congenital Heart Disease. The Journal of Thoracic and Cardiovascular Surgery. Jan. 2019; Volume 157, Issue 1: P 329-340. https://www.sciencedirect.com/science/article/pii/S0022522318323535?via%3Dihub
Mitral valve disease
Evolving techniques and a focus on mitral valve repair
Publication: Mitral Valve Operations at a High-volume Pediatric Heart Center: Evolving Techniques and Improved Survival with Mitral Valve Repair Versus Replacement. Annals of Pediatric Cardiology. Jan.-June 2012; Volume 5, Issue 1. https://journals.lww.com/aopc/fulltext/2012/05010/mitral_valve_operations_at_a_high_volume_pediatric.3.aspx
Tricuspid valve disease
Tricuspid valve repair with Norwood procedure for babies with HLHS
Publication: Tricuspid Valve Repair Concomitant with the Norwood Operation Among Babies with Hypoplastic Left Heart Syndrome. European Journal of Cardiothoracic Surgery. Oct. 2022; Volume 62, Issue 4. https://doi.org/10.1093/ejcts/ezac033
Tricuspid valve repair with Cone repair for Ebstein’s
Publication: The Association of Age and Repair Modification with Outcome after Cone Repair for Ebstein's Malformation. Seminars in Thoracic Cardiovascular Surgery. Spring 2022; Volume 34, Issue 1: P 205-212. https://www.sciencedirect.com/science/article/abs/pii/S1043067921001829
Truncal valve disease
Simple leaflet repair
Publication: Aortic Valve Repair in the Pediatric Population: Midterm Outcomes Comparing Leaflet Repair Using Autologous Pericardium Versus Porcine Intestinal Submucosa (Cormatrix®). The Journal of the American College of Cardiology. March 2017; Volume 69, Issue 11: P 557. https://www.sciencedirect.com/science/article/pii/S0735109717339463?via%3Dihub
Complex leaflet repair/bicuspidization
Publication: Symmetric Bicuspidizing Repair for Patients with Congenital Aortic or Truncal Valve Disease. The Journal of Thoracic Cardiovascular Surgery. Aug. 2023; Volume 166, Issue 22: P 283-291. https://www.jtcvs.org/article/S0022-5223(22)01131-X/abstract
Valve-sparing aortic root repair
Publication: Valve-sparing aortic root replacement and remodeling with complex aortic valve reconstruction in children and young adults with moderate or severe aortic regurgitation. The Journal of Thoracic Cardiovascular Surgery. June 2014; Volume 147, Issue 6: P 1768-1776. https://www.sciencedirect.com/science/article/pii/S0022522314002621?via%3Dihub
Ozaki procedure
Publication: Congenital Aortic and Truncal Valve Reconstruction Using the Ozaki Technique: Short-Term Clinical Results. The Journal of Thoracic and Cardiovascular Surgery. May 2021; Volume 161, Issue 5: P 1567-1577. https://www.jtcvs.org/article/S0022-5223(20)30438-4/fulltext
Pulmonary valve disease
Ozaki procedure
Publication: Pulmonary Valve Reconstruction Using the Ozaki Leaflet Reconstructive Techniques. The Annals of Thoracic Surgery. Jan. 2021; Volume 111, Issue 1: P. E19-E21. https://www.annalsthoracicsurgery.org/article/S0003-4975(20)30887-0/fulltext