Mending Babies’ Hearts and Minds

V. Mohan Reddy, MD, operates on the heart – one of the human body’s most complex organs – when it’s still the size of a grape. Reddy, co-director of the Pediatric Heart Center at UCSF Benioff Children's Hospitals, performs innovative procedures on the tiniest infants. He and his team fix defects previously thought to be inoperable in premature and extremely low birth-weight newborns. 

But healing hearts is only part of the challenge. Working with specialists in fetal medicine, neuroscience, and genetics, UCSF cardiac surgeons also devise new ways to ensure healthy brain development, which heart problems can complicate. 

Each year, more than 32,000 babies in the US are born with heart defects ranging from simple holes between the organ’s chambers to more complex malformations, like missing chambers or valves. About 20 percent of children with such defects require surgery. But even when it’s successful, surgery isn’t a cure-all; 50 percent of children whose hearts are repaired later develop neurological or brain impairments, from attention-deficit disorder to cerebral palsy. 

UCSF has led the effort to better understand the basis of congenital heart defects. To prevent lifelong neurological problems, UCSF cardiologists Shabnam Peyvandi, MAS ’18, MD; Hitendra Patel, MBBS; and others collaborate with geneticists and genetics counselors to diagnose heart problems in developing fetuses. Then they coordinate the care of those judged at risk with the specialists at UCSF Benioff Children’s Hospitals’ Fetal Treatment Center. This multidisciplinary approach helps pinpoint genetic markers indicating which babies with congenital heart defects are most likely to develop neurodevelopmental problems. 

Determined to prevent such problems, they’re studying whether giving supplemental oxygen to expectant mothers before they deliver their babies helps enhance the babies’ brain development after birth.