Stories about: fetal medicine

8 steps to succeed at a risky medical “first”

James Lock, MD, Cardiologist-in-Chief, Children's Hospital Boston

Ever since second grade, when he was suspended from school, Jim Lock has challenged the status quo — in sixth grade pulling off the much harder feat of being expelled. Today, the Cardiologist-in-Chief at Children’s Hospital Boston is credited with a long list of pioneering cardiac procedures going back to 1979, many of them in children with congenital heart defects. More recently, these have included fetal interventions, like reversal of hypoplastic left heart syndrome and implanting a stent in a fetal heart. Nearly all are now established procedures in pediatric cardiology.

These procedural innovations didn’t arise from a rare flash of inspiration, Lock argues, but from perception of a medical need followed by methodical vetting and sometimes years of due diligence.

“Innovation is not a completely random event,” Lock told the Innovators’ Forum at Children’s last week, sponsored by the Innovation Acceleration Program.  “It’s a process.”

Here’s Lock’s instruction set for safe and successful clinical firsts:

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Could amniotic infusions improve lung development?

An obstructed urinary tract, viewed on fetal ultrasound

Babies whose urinary tracts are obstructed before birth are at risk for a life-threatening complication: being born with poorly developed lungs. But surgeon Grace Nicksa, MD believes lung development could be preserved if the mother’s womb were infused with enough fluid at the right time in her pregnancy.

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