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Kids With Heart Disease Face a Brighter Future

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Times Staff Writer

Within the next decade, heart and heart-lung transplants may become so common in young children that they could replace a variety of surgical procedures now performed to repair pediatric heart defects.

Moreover, a range of new laser surgical procedures and other techniques--including use of electronic beams directed to the heart from outside the body to permit cutting away of diseased muscle tissue--will probably be in routine use in 10 years, according to a Texas pediatric-cardiology specialist, whose speculations appear in the American Heart Journal.

There will be far greater use of tubes with expandable balloon mechanisms inserted into the bodies of children, he said. These catheter techniques will be relied on to correct several severe defects that now require full-scale surgery.

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Diagnostic Techniques

Dr. Arthur Garson of the Texas Children’s Hospital in Houston also urged pediatric heart specialists to come to grips with the role of abortion as an alternative when advanced fetal diagnostic techniques before birth reveal catastrophic heart defects.

“It will be important for each member of the pediatric-cardiology community to examine his or her own views,” Garson concluded, because the issue of abortion and severe congenital heart defects “is not going to disappear.”

But for many youngsters with heart problems that are now uncorrectable, an expanding range of therapeutic weapons will make possible earlier and advanced surgery. Reliance on transplants will greatly increase, Garson said, and “it may be that in certain cases, ‘corrective’ surgery as we know it after birth may be replaced by cardiac transplantation.”

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By 1997, Garson said, the demarcation point between pediatric and adult cardiology may be so blurred that the children’s specialty will have to be renamed and its practitioners will focus on patients from the time of conception until about age 40.

“Ten years from now,” he concluded, “it is likely that the science and practice of pediatric-cardiology will be vastly different.”

New Longevity Frontier

The life expectancy of Americans, which had appeared by some measures to reach a plateau in 1984 and 1985, began to rise again last year, with the average American born in 1986 able to expect a life span of 75 years--up nearly three months since 1985. The development is being called a “major increase.” Between 1982 and 1985, life expectancy had increased less than one month a year.

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The trend, identified by Metropolitan Life Insurance Co. statisticians from data gathered by the federal government’s National Center for Health Statistics, indicates that baby boys born in 1986 will live an average of 71.5 years and girls will survive to 78.5.

Metropolitan Life statisticians noted that the increase in life expectancy occurred despite potential downward influences from such medical complications as influenza mortality, cancer and even AIDS. Falling heart-disease death rates and some improvement in infant mortality offset those negative factors.

“The social and economic implications for the next century could be profound, indeed,” a Metropolitan Life report concluded, “if these life-expectation levels continue to increase.”

Vitamin B6 and PMS

Taking Vitamin B6 to alleviate symptoms of premenstrual syndrome--a practice made popular by consumer books and magazine articles--carries with it the risk of side effects dangerous enough that women should exercise extreme caution in using this type of PMS treatment, according to a new study.

The caution, urged researchers Kim Kendall and Paula Schnurr of the University of Massachusetts and Dartmouth Medical School, is appropriate even though a test on 55 women found that the vitamin treatment is at least somewhat effective in relieving symptoms of dizziness and vomiting and even some behavioral changes characteristic of PMS.

The risk occurs, the researchers reported in the journal Obstetrics and Gynecology, because of the known toxicity of Vitamin B6, sometimes known as pyridoxine. In the study, the 55 subjects were given either Vitamin B6 or a placebo during a two-month period.

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Even in many women who reported certain PMS problems were lessened by the vitamin treatment, the symptoms did not completely disappear. The researchers also compared their results with previously published research reports, which have been divided in their findings on the usefulness of vitamins in PMS.

“Physicians recommending Vitamin B6 should convey appropriate precautions to their patients,” the researchers concluded, “as popular lore holds that this vitamin is unharmful and of likely benefit.”

Medicine in Brief

- Three Greek physicians say a study they performed on 187 men, broken down into groups that took afternoon naps and those that did not, leads to the conclusion a 30-minute siesta may play a significant role in preventing coronary heart disease. In the journal Lancet, the Greek group said nighttime sleep seems to have no preventive role, but a siesta may.

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