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Stanford Report, November 7, 2001

New pediatric team is good news for kids with severe heart defects at Packard

By KRISTA CONGER

Congenital heart defects occur in about 1 percent of all newborns, and about one-quarter of these infants will need surgery to correct their condition. Over the years, hundreds of children and their families have relied on the physicians, nurses and support staff at the Childrens Heart Center at Lucile Packard Childrens Hospital to repair their hearts and allow them to live normal lives. Last week, world-renowned cardiac surgeons Frank L. Hanley, MD, and Vadiyala Mohan Reddy, MD, joined surgeons Michael Black, MD, and Bruce Reitz, MD, at the center.

"Drs. Hanley and Reddys wealth of knowledge and experience, combined with our existing world-class team, establishes the childrens heart surgery program at Packard as a national leader in the treatment of pediatric heart conditions," said Christopher Dawes, president and CEO of the hospital.

Hanley, formerly professor and chief of the division of cardiothoracic surgery at UC San Francisco, will be the new director of the Childrens Heart Center. Reddy, previously an associate professor of surgery and director of pediatric cardiac surgery at UCSF, will be chief of pediatric cardiac surgery.

The newly formed team couples extensive experience with new and innovative treatments pioneered by Hanley, Reddy, Black and other physicians at the Heart Center to ensure that every patient receives the most advanced, comprehensive care whether their heart defect is commonplace or extremely rare.

"Our goal is to build one of the best cardiac centers in the country to provide care

for children with heart defects," said Reddy. One specialty of the Childrens Heart Center has been the development of minimally invasive surgical techniques to reduce pain and recovery time of their young patients. Black, associate professor of cardiothoracic surgery, has pioneered the use of robotically assisted cardiac surgery in children.

But the center doesnt focus exclusively on children. "We treat people with congenital heart disease over the entire age spectrum, from 1-day-old infants to middle-aged adults who have grown up with their condition," said Hanley. "As we get better and better at helping children with congenital heart defects survive, the number of adults living with these types of problems increases." Some of these adults have been undiagnosed, were diagnosed at a time when there was no effective treatment available for their condition, or have already undergone multiple surgical procedures.

Hanley and Reddy are particularly well known for their novel treatment of pulmonary atresia, a congenital condition in which the pulmonary valve is not properly developed and the heart is unable to efficiently pump blood to and from the lungs. The condition, one of the most complicated heart defects, has traditionally been treated with a series of surgeries and recovery periods. Without treatment, infants with pulmonary atresia have a life expectancy that is usually limited to weeks or a few years.

Hanley has pioneered a one-stage surgical treatment of the condition, called unifocalization, which decreases the amount of hospitalization time for patients and increases the likelihood that the defect can be repaired before the patients condition worsens or becomes ineligible for treatment. Each unifocalization procedure typically takes from eight to 10 hours, followed by 10 to 14 days of hospitalization.

Reddys primary interest is neonatal cardiac surgery on premature or low birth weight infants. The small size of the patients, coupled with the fact that many premature infants also have immature organ systems or multi-organ disease, make them a challenge. Optimizing their cardiac efficiency soon after birth boosts their overall health. Previously, these tiny infants may not have been considered for surgery or would have been given only palliative care.

"The average child with congenital heart disease will benefit tremendously from the infrastructure of a dedicated pediatric heart center and from the experience, compassion and dedication of the people involved," said Hanley. "Additionally, the complex cases will be in excellent hands at Packard."

Hanley earned his medical degree from Tufts University School of Medicine in 1978. He completed residencies at UCSF in general and cardiothoracic surgery then joined the faculty at Boston Childrens Hospital and Harvard Medical School before returning to UCSF in 1992.

Reddy earned his medical degree from Kakatiya Medical College in Warngal, India, and completed residencies in India as well as serving as senior resident in pediatric cardiac surgery at the Childrens Hospital in Boston. He has been at UCSF since 1992, serving as a fellow and then associate professor and as the director of pediatric cardiothoracic surgery.



Robots deemed to play expanding role in delicate surgeries