Iu Teixidó’s life is like that of any other 15-year-old. He studies, he plays football, he has no limitations. Not to have, he doesn’t even have scars. Only routine checks indicate that the boy had heart surgery less than two months ago, but only two incisions of 8 and 10 millimeters were made.
Minimally invasive heart surgery or using robotic technology was until now reserved for adult patients. This has changed. The Sant Joan de Déu hospital, in Barcelona, ??has performed interventions of this kind on children for the first time in Spain. And they have been a success: less admission time, much faster recovery and absence of scars.
This pioneering surgical program is part of the new alliance between Clínic and Sant Joan de Déu hospitals for the establishment of the Center for Congenital Pathologies, which will be in charge of monitoring patients throughout their life, from birth to old age . Based in both hospitals, the center has a team of 23 professionals that includes cardiologists, cardiovascular surgeons, pediatricians and anaesthesiologists.
“We are making great progress in comprehensive and integrated care for these patients throughout their lives”, explained the Minister of Health, Manel Balcells, at the presentation of the new centre. Every year, 600 children are born in Catalonia with congenital pathologies that require treatment, he emphasized. Among the creatures with these malformations in the heart and large vessels, a third are serious cases and another third require surgery in the first year of life, explains surgeon Daniel Pereda, director of the center. About 10,000 adults live in Catalonia with congenital malformations, a pathology that affects 1% of births. Thanks to the advances of recent decades, 95% reach adulthood, but with very specific needs.
Minimally invasive surgery or with the help of robotics is common in adults. The Clinic accumulates 243 interventions with these technologies, which avoid opening the entire thorax and fracturing the sternum: only very small incisions are made to access the organs.
The measurements of the instrument, designed for adults, and of the patients has been making it difficult to apply this technology to children. But now professionals have challenged the limits ihan done the first five pediatric operations. The first patient with robotic surgery was a 13-year-old girl from the Basque Country. The second, the Catalan Iu Teixidó.
One of Iu’s brothers, also with congenital heart disease, was operated on using the conventional technique. “I was very afraid because he has a very big scar”, explained the boy. It hasn’t been two months since the operation and he can lead a normal life, he doesn’t take any medication and plays football. “What used to bother him is whether he could make deadly shots to celebrate the goals. Can. He is fully recovered. It has no limitations, which is our goal when we treat patients”, explained Esther Aurensanz, specialist in pediatric cardiology.
In three of the five minimally invasive pediatric interventions that have been performed so far, professionals have opted for thoracoscopic surgery, which consists of making small incisions in the chest to insert, respectively, a device with a video camera and the instruments necessary for the intervention.
In the other two cases, the doctors opted for robotic surgery. Candidates for this technology are those with atrial fibrillation problems that cannot be resolved with catheterization, problems with the mitral or tricuspid valves, or heart tumors.
The plan is to operate on a dozen patients a year using robots and start with an annual activity of 20 thoracoscopic surgeries. The current minimum age limit for candidates is 6 years and 30 kilos. “A technological barrier that will evolve over the years”, according to Pereda. Patients are previously subjected to a selection process to determine the most convenient surgical option.
In the case of adults, the most common robotic heart surgery is mitral valve repair and patients are discharged in 3 or 4 days, in contrast to the 12 days of hospitalization for conventional surgery. The results are the same, what changes is the aggression that is carried out, which affects the recovery time and the possible complications of the healing process of the large wound.
