Children with tetralogy of Fallot, a complex heart defect characterized by four different anomalies, undergo their first open heart surgery in infancy, with more to come throughout life. But over the past several years, interventional cardiologists at The Children’s Hospital of Philadelphia have been performing a noninvasive procedure to replace a child’s pulmonary valve through a small incision in the groin, potentially reducing the number of open heart procedures the child will need over his or her lifetime.

CHOP offers this procedure combined with an advanced imaging technique called XMR, which combines X-ray and MRI images to create a detailed 3D picture of the child’s heart. “The more anatomic detail we can see, the better and the safer the procedure will be,” says CHOP interventional cardiologist Matthew Gillespie, MD.

“Before we even begin the invasive portion of the procedure, we have a complete understanding of the complex anatomy from the MRI, which provides exquisite anatomic detail without additional ionizing radiation. This is different than most centers in the world.”

CHOP currently performs 25 to 30 transcatheter valve replacements each year, and is the only pediatric center in the region to offer this procedure. Gillespie and his team are researching how to apply this technique to other types of pulmonary and mitral valve replacement, making noninvasive heart surgery available to more children.