It Takes Heart “As a “heart kid” herself, nurse Nichole Wenger finds her experience in Riley’s heart center and catheter lab especially meaningful. Born with pulmonary atresia (valve development problems) and ventricular septal defect (an opening in the ventricular wall), Wenger has had four heart surgeries at Riley; three of them open-heart, her first taking place shortly after birth. It’s easy to understand Wenger’s anticipation as she gathered intake information from Kimberly Baker, who was about to receive the Melody Valve implant. “This exciting procedure is done without open-heart surgery,” Wenger says. “No ICU, no stopping the heart, no heart-lung machine which is hard on the body.” Consequently, there are fewer complications and recovery time is faster: one day compared to months for open-heart patients. Patients receive the same high-quality Riley care, “It’s just simpler and less intense,” says Wenger who observed Baker during her brief Riley stay. Wenger considers herself an eventual candidate for the procedure – unless something more advanced develops in the future.

Innovative Care Offering new hope to children and adults with congenital heart defects, Riley Hospital for children at IU Health pediatric cardiologist Dr. Mark Hoyer pioneered a state-of-the-art procedure in 2011. “Up until now,” Hoyer says, “there hasn’t been a good, durable, long-term treatment for pulmonary valve disease. But the Melody® Transcatheter Pulmonary Valve is a game-changer.”

Approved by the FDA in January 2010, the Melody valve (made from a bovine jugular vein) is mounted inside a metal stent and delivered via catheter through a vein in the leg into the heart. Upon reaching the target location, a balloon inflates the stent, and the valve begins to work immediately. A big advantage is that this procedure is done non-surgically; doctors don’t have to open the chest cavity or stop the heart.

All replacement valves eventually fail, Hoyer points out, and patients will need additional treatments. While not a perfect solution, it meets patients’ immediate needs; keeping the heart functioning properly, improving their health and enhancing their chances for success with regular heart surgery later. It may also minimize the number of open-heart surgeries patients face in a lifetime.

Hoyer’s Melody implant patients include two teenagers and Kimberly Baker, the oldest recipient at age 37. Hoyer sees an increasing adult congenital heart patient population because improved medications and procedures have helped them survive longer.

Media attention surrounding Baker’s procedure has spread awareness of how Riley addresses the specialized needs of adults with congenital heart defects. It is Hoyer’s hope that more adults will be helped.

Riley Children’s Foundation is appreciative of the generoussupport you have provided to ensure expert care, compassionand comfort to all patients at Riley Hospital for Children at Indiana University Health.

n Congenital heart disease is the most common birth defect.

n Up to 1.3 million Americans live with some form of congenital heart defect.

n Each year, about 36,000 children (nine out of every 1000) are born with a heart defect in the United States.

n Since implementing the Pediatric Cardiac Critical Care Team in January 2009, Riley Hospital has seen a decrease in number of days patients require a ventilator after surgery, decrease in length of stay and boasts one of the best survival rates in the country.

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Changing Lives Kimberly Baker had been through it all. Born with a heart defect, she’d had two open-heart surgeries before age 30. Ten years later and on the brink of needing a third surgery, she learned of a revolutionary new procedure. As a patient of Riley Hospital’s Dr. Mark Hoyer, she became the first person in Indiana to receive the Melody® Transcatheter Pulmonary Valve. She was also the oldest patient on Riley’s pediatric cardiology unit. Accustomed to an active life, Kimberly noticed she was increasingly fatigued and short of breath. Almost immediately after the procedure, she felt better. “I had surgery in the morning and was walking the halls by evening!” Baker exclaims. “The Melody valve is a godsend, an amazing medical break-through. Life is ready to be lived again.” Almost 37 years old, she was surrounded by kids in a pediatric cardiology unit. “They all thought it was cool that they weren’t alone, that big people had heart problems too.” While having an adult on the unit rarely happens, “everyone was so understanding, making sure I was OK. I received the best care, as if I was one of the kids; it felt like family.” She went home the day after surgery and four days later was enjoying most normal activities. At 6 weeks, she was walking and biking. “I received a clean bill of health…perfect heart, no leakage.” The population of adults with congenital heart defects now outnumbers children with the same condition. “We are growing up now,” says Baker. Childhood procedures helped prolong life; now these patients need replacements or additional procedures. While the Melody valve offers only a 5 to 10-year “fix,” it is less invasive and easier on the individual than open-heart surgery. “With my kind of defect, I will have replacements throughout my life. Perhaps eventually another breakthrough will bring a longer-lasting procedure.”

“I received the best care, as if I was one of the kids; it felt like family.”

- Kimberly Baker

Dr. Hoyer examinesVictoria Chandler