Local researchers are working to perfect a device which will make it possible to go inside a baby's heart and safely snip away a piece of tissue.
The project, now in progress at Louisiana State university medical school, is another step in the endless quest for better methods of diagnosing heart ailments.
It is being spearheaded by Dr. Richard L. Fowler, presidentelect of the Louisiana Heart Association.
Dr. Fowler said the technique used involves inserting a catheter through an artery into the heart. Should the method prove safe, he added, it will give cardiologists a valuable tool with which to diagnose an ailment known as endo-cardial fibroelastosis.
Safety Stressed
"We haven't tried it out on human beings yet," added the physician, who heads the pediatric department at LSU, "We want to be sure first that it is absolutely safe.'*
Dr. Fowler said endocardia^ fibroelastosis is a heart ailment' which usually effects small infants.
"It's a conditon in which the inner lining of the heart is tremendously thickened,", explained the six foot, four inch physician, "the cause is not known. Sometimes a baby is born with it and many believe it is a congenital abnormality. Others think it is caused by an enzyme abnormality or possibily even an infection occurring in the baby before birth."
The pediatric-cardiologist said in a large number of c'ases the disease causes heart failure and eventually death.
"This is a very tragic situation," added Dr. Fowler, whose
desk is lined with pictures of youthful patients.
Device Described
The device, now under study, consists of a long, narrow plastic tube or catheter. On one end of the catheter is a small, rectangular metal gadget, equipped with buttons and wheels. On the other end is a tiny, cutting edge.
"First we make a small incision under local anesthetic," Dr. Fowler explained, "then we insert the catheter through this incision into the artery. We work the catheter into the heart until it rests against the inside wall of the heart. Then we are ready to remove the tissue."
The scientist said when the researcher presses a button on the rectangular gadget, attached to the outside end of the catheter, a tiny cutting edge emerges from the end of the catheter which is inside the heart. ,
Then the researchers turn a knurled wheel. And the tiny cutting edge begins to rotate. Negative pressure is exerted and the bit of tissue, which by now has been cut away, is sucked into the tip of the catheter.
Tissue Studied
After the catheter is removed, the tiny section of tissue is sent to the laboratory for study under, the microscope.
"We plan to use this technique in all cases in which we suspeci endocardia! fibroelastosis," Dr. Fowler explained, "if the laboratory confirms our findings, there'! not much we can do about it since, to date, we have no cure [for this heart ailment. - Medications to strengthen the heart beat are of some help, of course, but we are hoping that microchemical studies of the removed tissue may bring about a better understanding of this heart condition and that in time we will find an ef-y fective cure."
The pediatrician said in any event it is highly important to separate this disease from diseases which are more amenable to therapy.
Dr. Fowler was one of the first men in Louisiana to be trained to diagnose heart defects in children. His present project is being supported in part by a grant from the Louisiana Heart Association.
Main Varieties
The pediatrician said there are
two varieties of heart disease in
children; the one is caused by
congenital defects; while the oth-
is caused by rheumatic fever.
"There are man^ varieties of congential defects," he explained,
a matter of fact almost one out of every 100 newborn infants suffers from one of these defects. When you consider how many babies are born each year, this really mounts up."
The pediatrician said the "blue baby" we hear so much about is a baby who suffers from a congenital heart defect.
"Defects in the tetraology type of blue baby consist primarily of a hole in the wall between the lower chambers of the heart and an obstructed artery to the lung," he explained.
Surgery Helps
Dr. Fowler said most of the congenital defects of the heart can be helped by surgery. That is why it is imperative for such children to see a good heart physician early in life, he added.
The pediatrician said in the past rheumatic fever has been I responsible for a great many forms of valvular heart disease. Here, he added, surgery is a great help.
"But since the advent of penicillin," the scientist added, "such surgery is necessary less often. Adequate treatment of the strep-tococcal infections, which cause rheumatic fever, can prevent the initial damage to the heart valves while continued treatment to prevent new attacks can hold the damage to a minimum. PHOTO: DR. FOWLER EXAMINES EXPERIMENTAL CATHETER
Says it may give cardiologists valuable tool for diagnosis.
