Not Just for Kids

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Children’s Hospital of Wisconsin is treating more than just children. The hospital serves about 1,000 adult patients in its Herma Heart Center Adult Congenital Heart Disease Clinic, which was created about two years ago with the hiring of Dr. Michael Earing. Earing, the director of the clinic and an assistant professor of internal medicine and pediatrics at the Medical College of Wisconsin, is one of only approximately 35 physicians in the United States who has been trained in the last 10 years to care for adults with congenital heart disease. He received his training at the Mayo Clinic in Rochester, Minn.

Congenital heart defects are the most common birth defect in the United States. One out of every 100 babies is born with a heart defect of some sort, Earing said.

Years ago, many of those children did not live to adulthood. In the 1950s, doctors in the United States began performing heart surgeries to repair some congenital heart defects in children.

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Today, about 90 percent of the children who have those surgeries survive into adulthood.

However, doctors are discovering that those patients experience other heart problems that need to be monitored and treated later on in their lives. About 1 million U.S. adults are living with congenital heart defects, including about 15,000 in Wisconsin, Earing said.

That’s a lot of patients who likely will need additional medical attention for their heart defects.

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"We have this huge problem now of kids who were operated on when they were young who have grown into adulthood," Earing said.

Children’s Hospital created the Adult Congenital Heart Disease Clinic to care for such patients. The hospital is better able to care for them than most physicians who are not familiar with the medical history of those patients and are not experts in caring for adults who had heart defects as children, Earing said.

"(The patients) have unique problems related to their original problem and their original surgery," he said. "It’s a unique population with unique problems that are really individualized to each patient."

Health care professionals have only begun to learn about these problems in recent years as children who were treated for congenital health problems decades ago are getting older.

"In the 1960s and 70s, there were not many (medical) facilities doing these surgeries," Earing said. "Most patients had to travel a great distance to get to a hospital that did the surgery. In those days you would go and have the surgery. Instantly, the kids looked and felt better. Many went home and did well for years. But now as they become adults, they are experiencing new problems that we did not know existed."

Herma Heart Center Adult Congenital Heart Disease Clinic is treating those problems. The clinic is based at Children’s Hospital, but is a collaborative program that also includes Froedtert Memorial Lutheran Hospital and the Medical College of Wisconsin. The hospitals share expertise and some clinical resources with each other.

Depending on their individual situation, many adults who had surgery to repair congenital heart defects as children later have problems with abnormal heart beats or valve problems. They may need a pacemaker installed to eliminate their abnormal heart beat, or they may need valves repaired or replaced. Some need heart transplants.

In addition to treating their unique problems, the Adult Congenital Heart Disease Clinic is working to help adults living with congenital heart disease improve their lifestyles to prevent health problems from arising.

The program also helps patients handle the unique health and life insurance issues they will face, because of their medical background.

There are many people who were treated for heart defects as children who today are unaware that they will likely have more health problems, due to their congenital heart disease, as they age, Earing said. To learn more, visit: www.chw.org/display/PPF/DocID/30866/router.asp.

The clinic is also working to collect information and create data bases that will be used to help treat future adults who are living with congenital heart disease.

"We’re learning every day with this program," Earing said.

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