St. Joseph’s Children’s Heart Institute Implants 100th Pulmonary Valve Without Open-Heart Surgery

TAMPA, Fla. (Feb. 8, 2017) – When Cindy and Hershel Hancock began the process to adopt their son from China nine years ago, they learned that the then 4-year-old boy was born with tetralogy of Fallot, a complex condition made up of four heart defects that occur together, and underwent open-heart surgery at the age of 2. To prepare for what was to come, the Hancocks consulted with a cardiologist and learned that even though Caleb would need more surgery in the future, his condition was “perfectly manageable,” giving them the reassurance they needed to proceed.

Since coming to the United States, Caleb, now 13 years old, has received semi-annual checkups with Elsa Suh, M.D., a pediatric cardiologist at St. Joseph’s Children’s Hospital. When the back pressure from Caleb’s leaky pulmonary valve indicated it was time to have it replaced, Dr. Suh referred the family to Pediatric Interventional Cardiologist Dr. Jeremy Ringewald, who is the medical director of the pediatric and adult congenital cardiac catheterization lab at St. Joseph's Children's Hospital.

“After anticipating the need for another open-heart surgery for nearly a decade, we were thrilled to learn that Dr. Ringewald could repair our son’s heart without the need for another incision,” said Cindy. 

On Feb. 6, 2017, Caleb was the 100^th patient in the hospital’s Heart Institute to receive a transcatheter pulmonary valve. After inserting a catheter into a vein in the upper leg, Dr. Ringewald guided a new valve up to Caleb’s heart and replaced his dysfunctional pulmonary valve. 

“It was a great day for the whole team,” Dr. Ringewald said. “The crew did an outstanding job!” 

In April 2011, Dr. Ringewald was the first in the region to replace a pulmonary valve without open-heart surgery utilizing a newly approved medical device called the Melody Transcatheter Pulmonary Valve. In October 2015, St. Joseph’s Heart Institute team began implanting the Sapien valve in the pulmonary position as well, allowing more patients a less-invasive option for pulmonary valve replacement.

The core group that trained for the Melody and Sapien valves has participated in all 100 of these procedures. During the past six years, the team has become a lot more efficient and insight has been gained with experience. 

“We know all the ins and outs of the technique and equipment so it helps us to push the technology forward to benefit more patients,” Dr. Ringewald pointed out.

For instance, for Caleb’s procedure, the team knew that a Sapien valve would work best because of the size of his valve landing area.

“We were able to deliver the valve at full adult size despite Caleb weighing less than 70 pounds,” Dr. Ringewald explained. “Because of this, Caleb may not need any other procedures for 10 or 20 years.”

The team in St. Joseph’s Heart Institute have implanted the most transcatheter pulmonary valves in Florida since the program’s inception six years ago. "One hundred implanted valves mean that we helped 100 patients avoid additional cardiac surgery," Dr. Ringewald notes. 

The Hancocks are grateful for the new technology. “We are amazed at how well Caleb is doing,” Cindy said. “His recovering will be significantly shorter than what it would have been with open-heart surgery,” Cindy said.