Specialized Pediatric Cardiac Surgery with Dr. Elisabeth Martin

A new Pulmonary Artery Reconstruction (PAR) program at Lurie Children's is offering a complex surgical procedure that repairs or rebuilds the blood vessels responsible for carrying blood from the heart to the lungs. Pediatric cardiothoracic surgeon, Dr. Elisabeth Martin, was appointed Director of the program at Lurie Children’s. She is one of the few surgeons in the country with expertise to perform this complex surgical procedure that repairs or rebuilds the blood vessels responsible for carrying blood from the heart to the lungs. In this episode, she describes how this procedure can support the long-term heart and lung health of children in need of this intervention and how she plans to continue developing innovative surgical approaches that can transform young patients' lives.

Show Notes 

• Dr. Martin is French Canadian and after completing her medical school and cardiac surgery residency in Quebec, she sought out advanced congenital heart surgery training across North America and spent more than seven years refining highly-complex surgical techniques.
• Pulmonary artery reconstruction became an important focus of her work after training with the pioneer of the procedure, where she learned to treat children with Tetralogy of Fallot and pulmonary artery abnormalities. She says as babies, these children are often “blue” due to poor oxygenation caused by abnormal blood flow to the lungs, and that surgery is the only definitive way to correct the problem and allow the heart and lungs to function normally.
• Pulmonary artery reconstruction brings together abnormal vessels, closes large holes in the heart with patches, and restores proper blood flow so children can grow, develop, and live without chronic oxygen deprivation. She says when a child’s skin turns from blue to pink after surgery, it is one the most powerful and rewarding outcomes families first notice.
• This and other advanced procedures she conducts can be technically demanding, but they may prevent the need for heart-lung transplants, even in teenagers with heart failure.
• She reminds families that despite the complexity of these procedures and the long duration, some last up to 20 hours, she has trained for these procedures like an athlete trains for an Ironman race, and she is conditioned to handle even the most extreme cases.   
• Innovation and research are central to the PAR program’s future and Dr. Martin is interested in studying why some children are born without pulmonary arteries and how genetic and molecular factors affect long-term outcomes. 

Transcript

[00:00:00] Erin Spain, MS:
This is Precision: Perspectives on Children's Surgery from Ann & Robert H. Lurie Children's Hospital of Chicago. I'm your host, Erin Spain. On this podcast, we introduce you to surgeons at one of the country's most renowned children's hospitals to find out how they are transforming pediatric medicine.

Today we're talking with the leader of a new program at Lurie Children’s that will help transform the lives of children born with some of the most complex heart and lung conditions. Dr. Elisabeth Martin was named the director of the Pulmonary Artery Reconstruction Program and Surgical Outcomes Research. She has joined a team of experts within Lurie Children’s Heart Center to advance care for children with complex congenital heart disease and to continue developing innovative surgical approaches that can transform these young patients' lives.

We welcome her to the show to talk about her areas of expertise and what's in store for patients seeking care through her new program. Welcome to the show, Dr. Martin.

[00:01:08] Dr. Elisabeth Martin:
Thank you for having me.

[00:01:09] Erin Spain, MS:
So tell us a little bit about your background — where you grew up, where you came from, and what brought you here to Lurie Children’s.

[00:01:15] Dr. Elisabeth Martin:
I'm French Canadian. I was born speaking French only, and I did most of my training in Quebec — medical school in Montreal and cardiac surgery residency in Quebec City. After completing medical school and cardiac surgery residency, I wanted to complete congenital training, so I moved to Toronto. I spent some time in Boston as well, and then from Toronto, I made it all the way to California. I spent a little more than seven years in California at Stanford Children’s Hospital.

[00:01:42] Erin Spain, MS:
Let's start with the name of this new program at Lurie Children’s. What exactly is pulmonary artery reconstruction, and how did this surgical procedure become something that you are an expert in?

[00:01:53] Dr. Elisabeth Martin:
It’s exactly the reason why I decided to go to California in the first place. I wanted to learn something that’s quite cutting-edge and learn from the pioneer of the procedure, Dr. Frank Hanley, who through approximately 30 years of experience took care of some of the most challenging or extreme Tetralogy of Fallot patients using different types of procedures to eventually complete a full cardiac repair, so the babies would no longer be blue.

[00:02:22] Erin Spain, MS:
What do you mean when you're talking about these babies being blue?

[00:02:24] Dr. Elisabeth Martin:
Good question. At baseline, when you have Tetralogy of Fallot, the heart has four chambers, and there is a big hole in the heart. The vessel feeding the lungs, instead of coming properly from the heart, frequently comes from elsewhere in the body. Because there’s a big hole in the heart and the lungs are not receiving smooth or evenly distributed blood flow, those babies will not have an oxygen saturation of 100. They may have saturation in the eighties, seventies, or even sixties.

Frequently, we’ll see patients who require oxygen over the following months. There’s really no other treatment that will fix those babies except surgery. Oxygen is used to temporize.

[00:03:13] Erin Spain, MS:
By temporize, you mean managing symptoms temporarily while knowing surgery is the real solution later?

[00:03:20] Dr. Elisabeth Martin:
Yes. Sometimes they get a blood transfusion if they have anemia, again to temporize. If patients are very blue or have airway abnormalities, they may need CPAP at night or sometimes even a tracheostomy. All of these strategies are really just to buy time.

The only way to fix the blueness is surgery — recruiting all the vessels together, closing the hole in the heart with a patch, and placing a pulmonary valve. Surgery allows the heart to pump efficiently, so blue blood goes one way, red blood the other, and the child can grow and do all the normal baby things.

It became one of my favorite procedures. Not many hospitals or centers tackle this type of pathology due to its complexity and rarity, so you need to build dedicated expertise and a full team committed to caring for these patients.

[00:04:40] Erin Spain, MS:
What’s that like for family members to see their baby’s color change and improve?

[00:04:45] Dr. Elisabeth Martin:
It’s usually quite shocking. There’s a lot of preoperative education — parents learn to measure oxygen saturation at home and recognize color changes. They become accustomed to seeing saturation in the eighties or seventies and watching lip color closely.

Then after surgery, when you tell them saturation is now 100 and their baby is pink, it’s incredibly rewarding. It’s the first thing they notice — the color of their baby — and it’s a very meaningful moment.

[00:05:19] Erin Spain, MS:
Pulmonary artery reconstruction gives kids another chance at life. Can you share examples or stories?

[00:05:30] Dr. Elisabeth Martin:
I have a few stories.

[00:05:31] Erin Spain, MS:
I bet.

[00:05:32] Dr. Elisabeth Martin:
Even though it’s a rare procedure nationally, I personally perform about one per week, which helps build expertise.

One teenager I remember came in with heart failure. The heart had been pumping against obstructed pulmonary flow for years and was becoming weaker. The pulmonary vessels were also damaged from prior surgeries and stents. The options were either a heart-lung transplant or attempting a repair to preserve the heart.

I performed a repair to avoid a heart-lung transplant, which is not ideal if it can be avoided — especially for children. The surgery was successful. The patient returned to school, went to concerts, and was doing great a year and a half later. The heart recovered, the lungs recovered, and I don’t think this patient will ever need a heart-lung transplant.

These surgeries are complex, but they work. They can avoid transplantation — with the right team and dedication.

[00:07:12] Erin Spain, MS:
Another procedure in your expertise is the unifocalization reconstruction procedure, which saves some children from needing three surgeries. Tell me about it.

[00:07:24] Dr. Elisabeth Martin:
Historically, surgery was done in three steps: first reconstructing the right lung, then the left lung, and finally completing the heart repair through a third incision. That meant three surgeries, three sedations, and three recovery periods.

During that time, the unrepaired lung could worsen, and patients could become sicker. I learned a one-stage approach in about 75% of cases, where everything is repaired in a single surgery — both lungs and the heart.

These procedures can last eight to 20 hours depending on complexity, but the goal is to fix everything at once, avoid lung deterioration, and prevent patients from getting sicker in between surgeries. It’s a bigger step in one sitting, but it’s effective.

[00:08:52] Erin Spain, MS:
You perform some of the most technically demanding surgeries in pediatric cardiac care. How do you prepare?

[00:09:06] Dr. Elisabeth Martin:
Families often ask how I stay focused for 10 to 20 hours. I started with less complex cases and gradually built comfort with three-dimensional reconstruction and handling extremely small vessels.

Over time, as I gained experience and confidence, I took on more complex cases — especially when the alternative might be transplantation. It’s like training for a marathon: you start small, then build endurance. The same applies to surgery, and it’s a team effort — not just me in the operating room.

[00:10:32] Erin Spain, MS:
Lurie Children’s is home to one of the nation’s top pediatric heart centers. How does your program build on that?

[00:10:46] Dr. Elisabeth Martin:
I joined a team that is excited about innovation and building on an already strong foundation — cardiologists, anesthesiologists, perfusionists, ENT surgeons, ICU teams, nurses, and more.

It’s a multidisciplinary approach with a strong existing culture of collaboration. Everyone was enthusiastic about expanding capabilities and incorporating these complex patients. I think this program complements what Lurie Children’s already does exceptionally well.

[00:11:44] Erin Spain, MS:
What role does innovation and research play in your work?

[00:11:56] Dr. Elisabeth Martin:
Surgical innovation is challenging because you must balance risk against known outcomes. Even if procedures exist elsewhere, bringing them into a new system requires alignment, education, and infrastructure.

Innovation is exciting, but it requires strong organizational coordination and trust across teams.

[00:12:40] Erin Spain, MS:
What about the research component?

[00:12:42] Dr. Elisabeth Martin:
I’m researching why some patients are born without pulmonary arteries and why they fall on the extreme end of Tetralogy of Fallot. There’s much we don’t understand genetically and molecularly.

We’re also studying syndromes such as Alagille syndrome, Williams syndrome, and elastin arteriopathy — conditions that affect vessel structure. Understanding why some patients have more severe disease is an ongoing focus.

[00:13:45] Erin Spain, MS:
You treat neonates, teenagers, and adults with congenital heart disease. Tell me about that spectrum.

[00:14:00] Dr. Elisabeth Martin:
I’ve been fortunate to work across the full age spectrum — from premature newborns to adults. Pediatric congenital surgery allows you to follow patients throughout their lives.

There are still many unknowns in adult congenital heart disease, especially for patients with multiple prior surgeries. Neonatal surgery is particularly delicate, and I also have experience with transplant and mechanical support. Covering the full spectrum has been incredibly rewarding.

[00:15:14] Erin Spain, MS:
What made you want to bring your skills to Lurie Children’s?

[00:15:23] Dr. Elisabeth Martin:
The Midwest has a large patient population, and I’ve seen patients traveling from across the country. The team here is enthusiastic, collaborative, and eager to build something new.

The opportunity to work with new colleagues, learn from their expertise, and tackle complex challenges made this an exciting decision.

[00:16:00] Erin Spain, MS:
What do you want families to know about the care they’ll receive?

[00:16:08] Dr. Elisabeth Martin:
Care is comprehensive — it starts before surgery with education, planning, and discussion, continues through surgery and hospitalization, and extends long-term.

Families need to understand timelines, expectations, and the likelihood of future interventions, especially since pulmonary valves don’t grow with children. Long-term follow-up is essential, and the team here supports families every step of the way.

[00:17:19] Erin Spain, MS:
It’s the beginning of a long-term partnership with families.

[00:17:30] Dr. Elisabeth Martin:
Exactly. It’s like going to the dentist — even if things are going well, you still need ongoing checkups. Cardiology is similar. It’s almost like a lifelong membership.

[00:17:47] Erin Spain, MS:
Just becoming part of the community.

[00:17:49] Dr. Elisabeth Martin:
Yes.

[00:17:50] Erin Spain, MS:
Yes.

[00:17:51] Dr. Elisabeth Martin:
Absolutely.

[00:17:51] Erin Spain, MS:
Thank you so much, Dr. Elisabeth Martin, for sharing your insights today. This is incredibly valuable for families learning about this program at Lurie Children’s.

[00:18:04] Dr. Elisabeth Martin:
Thank you for having me. I appreciate it.

[00:18:06] Erin Spain, MS:
For more information, including how to make a referral or an appointment, visit luriechildrens.org.

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