Michael Harrington, President & COO of Nicklaus Children’s Hospital, Miami, and Kristine Guleserian, M.D., Cardiovascular Surgeon, spoke at the Naples Press Club 2017 Annual Meeting and Holiday Celebration Lunch, December 14 at Tiburon Golf Club.
“Children are not little adults,” Harrington said. “We focus on pediatrics, cardiac, orthopedic and oncology. We have had children come to us who were not able to be diagnosed. We are able to better diagnose children because that is our specialty. Our role is to provide help and well-being of children. For us it’s about figuring out what we do best while also being a part of the community. Thus, going forward, we’re opening a branch of Nicklaus Children’s Hospital in Naples at 659 5th Avenue South. We are going to continue to create that advocacy for children, and now in the Naples Community, too.”
Harrington added, “One of our goals is to keep children in their homes, if possible. Naples Community Hospital has strong children’s care facilities, so that our children and their families are able to return to Naples and be in their own homes. It’s easier on the children and their parents.
“We are a teaching hospital, the largest program in the Southeast, which provides us with the opportunity to access a broad spectrum of physicians. Our heart program is one of the few very large programs able to utilize state-of-the-art technology for a very large neurosurgeon component. We want to be one of the top children’s hospitals in the nation,” Harrington stated.
Kristine Guleserian, M.D., is a pediatric cardiovascular surgeon and the director of Heart Transplantation at Nicklaus Children’s Hospital. She said that the most common cause of death in infancy is from congenital malformations. “CHD (Congenital Heart Disease) is the most common birth defect, affecting 1 percent of all newborns, 40,000 new cases every year in the United States alone, and 25 percent of those require surgery before one year of age. Worldwide many patients with CHD go untreated and die.”
She showed the NPC members, scholarship students and guests in attendance some photos of the development of the embryo. “Hearts are the first part of the embryo to develop. By the first few weeks of gestation the heart begins beating—long before most women even realize that they are pregnant,” said Guleserian.
“It was in the early 1950s that the cardiopulmonary bypass machine was first used, and it was developed using technology from the beer and dairy industries,” she said. “December 3rd of this year marks the 50th anniversary of the first human heart transplant, performed by Dr. Christiaan Barnard in Cape Town, South Africa. Barnard trained at the university there and in the USA (visited Dr. Norman Shumway at Stanford University).”
Because of the innovations, CHD surgeries in the 1960s. Recently, Guleserian operated on a tiny baby who was born at only 21 weeks of gestation. “You could hold him in the palm of your hand,” she said. “He survived.
“Heart failure in children is a growing problem. While the number of patients needing heart transplants is increasing, the number of donors has remained the same. For example, all patients born with single ventricle heart physiology will need a heart transplant at some point in their lives,” she said.
“We recently cared for and operated on several infants from Puerto Rico after the recent hurricane damage. For their families it was devastating to be evacuated from their homes but the hospitals there were incapacitated. I have the capacity to watch the baby’s vitals from my home, and I also reviewed their updated charts in the drive over here today.
“What’s on the horizon?” Guleserian asked. “More money is needed. Heart surgeries and transplants are very expensive. We need newer devices, perhaps a total artificial heart someday.”
Q: What about children without insurance?
A: Nearly 70 percent of our patients are on Medicaid, and it doesn’t begin to cover the costs.
Q: I read recently that a baby was born with a heart outside the body.
A: That is very rare. I have operated on that condition only three or four times in my career.
Q: How many transplants are done in a year?
A: In small pediatric heart transplant programs, one to four in a year; in medium pediatric heart transplant programs, five to nine; in large pediatric heart transplant programs, at least 10 a year. Before joining the Miami, my team in Dallas performed 17 heart transplants. Quantity is one thing; quality is another!