Dr. Evan Zahn at Cedars-Sinai continues to innovate for infants with heart defects

September 19, 2017
Dr. Evan Zahn performs surgery on a patient. Photo courtesy of Cedars-Sinai Heart Institute.

The large desk inside Dr. Evan Zahn’s Cedars-Sinai Medical Center office overlooking Beverly Boulevard has a 3-D printed model of a human chest, revealing veins, arteries and, of course, a human heart — the primary focus of his work for more than 30 years.

“It’s a model of an actual patient,” he said.

Zahn, 57, showed how a small metal device could be inserted into the heart through a catheter that would unsheathe once inside, replace a faulty pulmonary valve and improve blood flow.

“It can last 10 or 15 years, and maybe we just put in another valve then, kind of like a Russian [nesting] doll,” he said. “We can save many patients open-heart surgery.”

One patient he helped save was Jimmy Kimmel’s infant son, Billy, whose heart defect was first diagnosed at Cedars-Sinai. In an emotional monologue on his late-night show in May, Kimmel thanked Zahn by name and used the episode to argue for making the same high-quality medical care available for all Americans.

A native of Long Island, N.Y., Zahn has been the director of pediatric cardiology at Cedars-Sinai’s Heart Institute since 2012. He’s one of the world’s pre-eminent experts at treating structural heart problems with minimally invasive procedures, particularly in children.

During a nearly 20-year stint as chief of cardiology at Miami Children’s Hospital in Florida before coming to Cedars-Sinai, Zahn rose to prominence, performing the world’s first nonsurgical tricuspid valve replacement via catheter on a 9-year-old boy.

Five years ago, it seemed like the right time for Zahn to take on a new professional challenge offered by Cedars-Sinai. He, his wife and four children moved from Miami to Pacific Palisades, where they’ve become members at Kehillat Israel, a Reconstructionist temple. He’s an avid runner and cyclist.

“I love it here,” he said. “When people ask me about the traffic in Los Angeles, I say there’s a reason so many people want to live here.”

Zahn was lured to Cedars-Sinai to head up a new Congenital Heart Disease Program and develop more minimally invasive treatments.

“Cedars is a household name, a widely respected place for treating heart disease,” he said. “There’s tremendous support here for doing new, creative and innovative things. I don’t think there’s a place anywhere that rivals this institution for that.”

One of the main attractions for Zahn in coming to Cedars-Sinai was the prospect of forming a congenital heart disease program in an adult medical center. Children’s hospitals, by nature of their charters, can’t treat patients over the age of 18. In many cases, Zahn had patients born with heart defects requiring lifelong medical attention and complex procedures age out of his care.

“I was having to send my patients away, and I hated it, but not half as much as they hated it,” he said. “So, one of the things that really drew me here was being able to take care of patients who need a lifetime of care at one institution with one singular team, from fetal diagnosis until old age.”

Cheryl Davis, 48, a lighting artist at Walt Disney Animation Studios in Burbank, is one of Zahn’s adult patients. She was diagnosed with a severe pulmonary valve regurgitation, or leaky valve, as a 9-year-old. Leaks in the pulmonary valve allow blood to flow back into the heart chamber before it gets to the lungs for oxygen.

Davis had open-heart surgery as a child to correct it but still had complications throughout adulthood, including a murmur and fatigue. After consulting numerous cardiologists, she was referred to Zahn. In late August, he performed a valve replacement on Davis, just as he demonstrated on the model in his office. She was back at work a few weeks later.

“I’m still taking things a little slow, but I don’t feel my murmur and my heart feels normal for the first time in my life,” she said. “[Zahn] has been amazing. On top everything, he’s just a really nice man and one of the most humble people I’ve ever met.”

Still, Zahn’s primary focus at Cedars-Sinai has been treating newborns, particularly premature babies, with structural heart problems. He estimated that as many as 15,000 premature babies are born each year with life-threatening congenital heart defects. These are babies born up to four months early that sometimes weigh as little as 1 pound and fit in a cupped adult hand. Zahn said doctors currently have two main treatment options, which work less than half the time and have significant side effects or complications linked to severe outcomes like blindness, deafness and mental disability.

At Cedars-Sinai, Zahn has made great strides in this area, dedicating time to research and development with colleagues and outside biomedical engineers. So far, he has treated 40 premature babies using a catheter to insert a small metal clamp that plugs harmful blood flow to a baby’s lungs, which causes disease in lungs, bowels and the brain.

“For premature babies, no one does that,” he said. “No one has gone into their hearts via catheterization.”

Zahn said he has a 90 percent success rate so far. No one has died, and babies he treated three years ago now look like other kids their age. In the remaining 10 percent of cases, he said additional conventional surgery was required. 

“There have been other people who have done other work in other countries, and some of that was very useful, but ultimately, I think the solution came from here,” he said.

Zahn almost feels guilty about how much personal satisfaction he gets out of saving lives.

“It’s almost a selfish thing that I do,” he said. “I get so much joy out of knowing that a baby, who without immediate medical care won’t survive, will be fine because I’ve seen their course so many times. Now that I’ve done this for nearly three decades, I’ve seen these babies grow up to play T-ball, play high school sports, get married and have kids. It’s remarkably gratifying.”

Cedars-Sinai is working with an industry partner to develop a clamp device uniquely designed for premature babies with heart problems and to get federal approval for it. The device, Zahn said, will be a self-expanding plug, fashioned to fit inside a catheter and made out of a metal called nitinol, or nickel titanium. The device used in the initial 40 cases was designed for other purposes.

Zahn, who recently spoke to a colleague in Japan whose hospital just treated its first premature baby, said he is confident that his efforts at Cedars-Sinai will have wide-reaching impact.

“We think we can make a big difference around the world with this,” he said. “It’s a very in-need population, and there’s not a lot made in general for premature babies. They don’t vote. They don’t get the attention they need. We think this is going to be a game changer.”

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