Challenges in education; Repairing congenital heart defects

Surgical procedures are so advanced now all that some congenital heart defects in children are being corrected before the patients reach school age. There are large numbers of children born each year with problems with their heart that may or may not require surgical procedures. Now all of these children obviously don't need anything done surgically. And it's our job really to follow these children and pick out the ones that do need surgery by using X-ray motion pictures and computers. Doctors are learning more about heart abnormalities in children. In a moment Dr. Tom Graham returns to talk about the heart function Studies at Duke Medical Center. Challenges in education presented by Duke University. Here with today's feature is Charles x ray motion picture studies of adult hearts have been conducted for some time. But a growing number of

medical centers are conducting them now with children by cardiac catheterization or inserting small tubes into the veins and arteries and passing them into the heart. Doctors can measure the pressures inside the heart. Dr. Tom Graham a pediatric cardiologist explains we can with the injection of radioisotopes we can quantitate the amount of of abnormal circulatory pathways that they may have putting in some instances an excessive amount of blood through the lungs. After we do this we even will take motion pictures of the inside of the heart and the great vessels. And this is done by injecting into the bloodstream through the catheter. A radio a paper material contrast media we call it which when it is films are exposed when this contrast media is inside the heart and it outlines the details of the inside. This will give us a picture really of the anatomy of the heart.

The x ray movies are shot from two angles simultaneously at 60 frames per second and when the film is developed the doctors can make a drawing and calculate the volume of the heart. Dr Graham explains how this may be done in the future. This takes some of mathematical manipulation which can be done by hand but it is time consuming. So we found that it's much. To our advantage to go to the computer for certain of the operations we can't automate yet the drawing up of the figure from the Phantom. We have plans to automate this in the future with the help of what is called a flying spot scanner which is just a sort of an electric eye which a person can trace around the outline of the heart and immediately then this information goes to a computer and the calculations are made. The calculations allow the doctors to determine how much work the heart is doing. We can also calculate using some proxy mation say

the force or tension developed in the walls of the heart and the speed of contraction that the heart does contract with. And this information we feel is giving us an idea about how well this heart is performing. Not only does it give us the information of how big the heart is and how much muscle mass it is and how dilated it is but also we think tells us how well it is performing its function. At this point we're just beginning to get the answers to tell us when these children should be operated on. What do these studies mean to the patient. Again here's Dr. Tom Graham. It gives us better judgment to decide if a child needs an operation when it needs to be done. With this in mind in particular in an individual patient It lets us decide when the time of surgical intervention would be optimal to give this patient the best chance for

continued survival and a long life. The entire effort is based on cooperation among human rights specialties. And this combined effort of doctors movies and computers may save or improve the lives of countless children. This is Charles Roswell with challenges in education from Duke University. This program was distributed by the national educational radio network.