Preemie Twins Have Hearts Repaired at St. Joseph’s Children’s Hospital

November 11, 2021
Dr. Jeremy Ringewald, pediatric interventional cardiologist, and Jennifer Carter, APRN, with preemie twins who had heart procedure at St. Joseph's Children's Hospital
Jennifer Carter, DNP, APRN, CPNP-AC, and Dr. Jeremy Ringewald, pediatric interventional cardiologist and the medical director of the Cardiac Cath Lab at St. Joseph's Children's Hospital, with twins Gerardo and Gustavo.


Twins Gerardo and Gustavo Pizano were born three months early and were both diagnosed with patent ductus arteriosus (PDA), a congenital heart defect that most often occurs in premature babies. In PDAs, a blood vessel in the fetal heart that is supposed to close after birth – the ductus arteriosus – remains open and allows blood that should flow to the body to instead recirculate to the lungs.  

Dr. Jeremy Ringewald, pediatric interventional cardiologist and the medical director of the Cardiac Catheterization Lab at St. Joseph's Children's Hospital, used the Amplatzer Piccolo Occluder to repair Gerardo’s and Gustavo’s heart. The Piccolo Occluder is a self-expanding, wire mesh device smaller than a pea and is the only device U.S. FDA approved to close PDAs in premature babies. 

“The Piccolo Occluder was designed specifically for very low weight preemies, and greatly increases our ability to close PDAs in the most medically fragile babies with little risk of interference with adjacent structures,” said Dr. Ringewald. 

During Gerardo and Gustavo’s procedures, Dr. Ringewald inserted a tiny catheter tube into a vein in the leg and guided the catheter into the PDA. He then advanced the self-expanding, wire mesh device through the catheter to spring open in the PDA, sealing it closed immediately. 
Both cardiac procedures were a success, and after spending months in St. Joseph’s Women’s Hospital’s Neonatal Intensive Care Unit (NICU), the boys are home and growing stronger each day. 

“We are so grateful we chose to have our babies at St. Joseph’s,” said the twins’ mother, Maria Pizano. “They received the very best care during their long stay in the NICU.”

Maria adds that while she was extremely anxious about Gerardo and Gustavo undergoing heart procedures as premature infants, she felt confident that they were in the best hands possible with Dr. Ringewald and St. Joseph’s Children’s Hospital’s pediatric cardiac team.

St. Joseph’s Children’s Hospital is home to the Tampa Bay area’s only comprehensive congenital heart and vascular program, and its pediatric heart physicians perform hundreds of cardiac procedures each year to treat congenital and acquired heart conditions in children of any age, including newborns. A partnership between St. Joseph’s Children’s Hospital and the Children’s Hospital of Pittsburgh of UPMC provides families across Florida with unprecedented access to the highest level of pediatric heart care available. Together, they provide highly specialized cardiovascular care for patients ranging from babies in the womb to adults with congenital heart disease.


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