World’s first ‘living tissue’ partial heart transplant saves boy born with fused arteries

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A 5kg newborn boy with a life-threatening heart defect received a world-first partial heart transplant with living tissue that may never need to be replaced.

North Carolina baby Owen Monroe, now four months old, was born with his two main arteries — the aorta and the pulmonary artery — fused together in a condition called truncus arteriosus.

Doctors separated them and replaced ‘leaky’ heart valves shortly after birth with living tissue that will grow with him, avoiding further surgery. In operations to repair fused valves, dead tissue is usually used – but it must be replaced in major operations up to three times before adulthood and every 10 years thereafter.

Now four months after the surgery at Duke University, North Carolina, the infant is ‘thriving’ and hitting every developmental milestone.

His mother, Tayler Monroe, called the procedure a ‘miracle’ and said it saved her son’s life.

Truncus arteriosus is usually a death sentence for infants without surgery, as the heart overexerts itself and struggles to get nutrients to every corner of the body. It’s also rare, with less than one in 10,000 American babies born with it.

Owen Monroe was born weighing 5 kg in North Carolina.  His parents signed him up for the partial heart surgery after being told they would have to wait six months for the full transplant, which could be too long for their son

Owen Monroe was born weighing 5 kg in North Carolina. His parents signed him up for the partial heart surgery after being told they would have to wait six months for the full transplant, which could be too long for their son

Pictured above is the surgery where Owen's fused arteries were separated and the valves in his heart replaced

Pictured above is the surgery where Owen’s fused arteries were separated and the valves in his heart replaced

In the picture, Owen is a few months after the operation, with the scar visible on his chest

In the picture, Owen is a few months after the operation, with the scar visible on his chest

Mum Tayler said it was 'miraculous' that her son had survived.  He is 'thriving' and reaching every developmental milestone in line with his peers

Mum Tayler said it was ‘miraculous’ that her son had survived. He is ‘thriving’ and reaching every developmental milestone in line with his peers

A normal heart

Owen's heart, which had a truncus arteriosus, or where the aorta and pulmonary artery are fused

NORMAL HEART AND OWEN’S HEART: Shown above is a normal heart (left) and Owen’s (right). He had a rare condition called truncus arteriosus. It is usually a death sentence without surgery

Parents Tayler and Nicholas Monroe said their son’s diagnosis left them with ‘few options’ as he was already likely to suffer heart failure shortly after birth.

They were told that the waiting list for a full transplant was about six months, which their son was unlikely to reach.

So they signed up for the experimental surgery at Duke University, which would use living tissue to separate the fused arteries.

What is trunk arteriosus?

This rare defect is where the two main arteries to the heart – the aorta and the pulmonary artery – become fused together.

The condition is usually a death sentence for infants without surgery.

But children typically need multiple surgeries throughout their lives to replace the valves as they grow — because they don’t grow with them.

What are the symptoms?

These appear within the first week of life and include

  • Bluish color of lips and nails;
  • Rapid breathing or difficulty breathing;
  • Poor feeding.

How is it treated?

Babies are treated quickly after they are born to avoid congestive heart failure, when the muscle stops working because it cannot pump enough blood to meet the body’s energy needs.

They are then offered surgery to separate the two arteries.

What is the survival rate?

About 90 percent of infants who undergo surgery live longer than 40 years.

The condition is rare, with less than one in 10,000 American babies being diagnosed with it.

Source: Cincinnati Children’s Hospital

About 90 percent of infants who receive the operation using tissue from a cadaver—the standard procedure—survive for more than 40 years.

But they will need at least three other surgeries in their lifetime to replace the tissue because they will grow, the American Heart Association says. It may also need to be replaced every ten years during adulthood.

When Owen was born, doctors discovered that as well as having fused arteries, he also suffered from a ‘leaky’ heart valve – which also needed to be replaced.

It is important to have good heart valves as they stop blood flowing back in the wrong direction and cut off circulation.

At the operation, he received living tissue and valves from another infant’s donor heart.

The heart had strong valves but was too weak to be used for a full transplant. The doctors said that without Owen’s surgery, it would not have been used.

After recovering and showing no side effects from the surgery, Owen was discharged and returned home.

Doctors say the youngster is now developing normally and his parents couldn’t be more thrilled.

Speaking before the birth, mum Tayler said: ‘It was basically like something happened [at birth] we would resuscitate him and hope for the best, which is really hard and scary to hear.

‘Nick and I had the conversation about Owen being here to be a donor for other babies, which is probably the hardest conversation you could ever have as a parent.’

But after the surgery and her son’s recovery, Tayler said it was ‘miraculous’.

“The fact that he’s not only okay, but he’s thriving, really gives a lot of hope for future babies going through this.

‘All his doctors are thrilled with how he is doing. He doesn’t behave developmentally at all, anything like that’.

Dr. Joseph Turek, a cardiologist who led the operation, said: ‘This procedure potentially solves the problem of a growing valve.

“If we can eliminate the need for multiple open-heart surgeries every time a child grows out of an old valve, we can extend that child’s life by potentially decades or more.”

In the operation, the doctors began by cutting the individual blood vessel (pictured above)

In the operation, the doctors began by cutting the individual blood vessel (pictured above)

They then used living tissue to replace the missing area of ​​the aorta and the missing area of ​​the pulmonary artery.  New valves were also added from the donor heart to control blood flow

They then used living tissue to replace the missing area of ​​the aorta and the missing area of ​​the pulmonary artery. New valves were also added from the donor heart to control blood flow

Owen's heart has since functioned normally.  Doctors hope the living tissue will grow with him and avoid the need for future heart surgery

Owen’s heart has since functioned normally. Doctors hope the living tissue will grow with him and avoid the need for future heart surgery

Dr. Michael Carboni, a cardiologist also at the university who consulted for the child, added: “What is particularly remarkable about this procedure is that this innovation is not only something that can extend children’s lives, but it uses a donated heart, which would otherwise not be able to be transplanted.

“The valves in this procedure come from a donor heart that had muscle tissue that was too weak to make it viable for a full transplant, but had strong valves that were suitable for Owen’s needs.”

Father Monroe said: ‘As harrowing as it was for our family, we knew from the start that Owen was in the best of hands.

“Our greatest hope is that Owen’s success story will change the way organ donation and transplants are handled not just for congenital heart disease babies, but for all patients.”

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