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Doctor repairs girl's heart without surgery Two holes filled in pioneering technique by Lynne Langley Of The Post and Courier Staff In what's thought to be a first in this country, a Charleston doctor permanently plugged two holes in the beating heart of an 8-year-old without surgery Thursday. The child checked out of the hospital less than 24 hours later. Rachel Burch could go back to school Monday if classes were in session, said Dr. Wolfgang Radtke, associate professor of pediatric cardiology at the Medical University of South Carolina. "This has pretty much been a piece of cake," said her father, Teddy Burch of Marble, N.C. "We've lived in hospitals. This has been an overnight visit." Born with multiple heart defects, Rachel had undergone open-heart surgery three times, the first at 4 days old. Until recently, closing a hole required open-heart surgery, which might not have been possible on the hole in a remote part of Rachel's heart, the doctor said. On Thursday, Burch carried his daughter into an MUSC catheterization lab. Radtke inserted a thin tube into her groin and slowly guided the catheter up a blood vessel to her heart and to the first hole. The tube held a compressed wire cage with a polyester center, resembling a plug with a disk on each side. When Radtke released it, the nickel titanium alloy cage sprang open to fill the void.First he performed the more challenging procedure, still experimental and under trial for federal Food and Drug Administration approval, deep within the lower, pumping chambers of the beating heart. Then he used a cath and similar Amplatzer device to fill the more accessible hole, as he had done more than 100 times during FDA trials. The FDA approved that device in December to treat atrial septal defect, known as ASD, in the upper chambers of the heart. To his knowledge, Rachel's 3 and 1/2-hour procedure is the first time in this country that the combination has been used at the same time. He estimates that only 40 to 45 patients nationwide have undergone the treatment for ventricular septal defect, VSD. In a few weeks, Rachel's own cells will have covered each device, Radtke said. "It grows into the heart, or the heart grows over it." The first ASD devices were experimentally placed six years ago, and those patients are doing well, Radtke said. Last year when Rachel had open-heart surgery in Michigan, she spent nearly two weeks in intensive care and another week in the hospital, followed by complications and a return to ICU, Burch recalled. "There's no comparison. It's like going to the dentist," he said. In the first six months, about 1,000 Americans received the new ASD device. "We now do it routinely," said Radtke, although he is the only physician in the state performing the procedure. "VSDs are a much more unusual undertaking, much more difficult and complicated," he said. "It's deeper in the heart, in a more remote location, and the heart keeps moving." In all, 20 medical centers are participating in the FDA trial and a few more are testing a second, similar device, he said. Radtke has performed six of the 40 to 45 procedures in this country and said that the VSD treatment is promising. "There is no pain, no scar and no need for recovery time." In comparison, he said, "It's a pretty big deal going through heart surgery." The cath lab procedures took less emotional and physical toll on Rachel, her father said. By the next day, she was eager to get home to friends, dancing and singing.  She still has one leaking valve that will need treatment, but now—for the first time—no holes force her heart to work too hard, Burch said. Burch is relaxing a bit, too. Because of her heart problems, he said, he never felt he could let down his guard. "It changes your perspective on life, on what's important." Reprinted with permission from The Post and Courier, Charleston, S.C.