Every year, thousands of children around the world are born with heart defects that need complex surgeries and lifelong care. For their families, it’s a hard and emotional journey full of questions, fears, and hope for what lies ahead. In times like these, having a skilled, compassionate surgeon by their side can truly change everything. That’s where Dr. Luciana da Silva comes in. She is a cardiothoracic surgeon at UPMC Children’s Hospital of Pittsburgh, who has dedicated her life to caring for children with serious heart conditions, especially a rare one called Ebstein’s anomaly. During her time practicing medicine, she continuously improves surgical approaches that can lead these children toward a full life expectancy. Her medical work extends past treatment to create opportunities for children while providing hope to families during difficult times.
But Dr. Luciana da Silva didn’t always plan to become a heart surgeon. Her path into this demanding field wasn’t exactly a straight line. She grew up in Brazil, and in the beginning, she actually started out in engineering. She loved numbers and solving problems and thought that would be her future. But when the country’s economy shifted and engineering careers became uncertain, she made a big decision and switched to medicine. That choice, guided by instinct and resilience, ended up changing her life and the lives of so many children and families along the way.
Dr. Luciana da Silva is using expertise to give children with heart defects a brighter future!
From Engineering to Medicine
Dr. Luciana da Silva didn’t follow a traditional route into medicine; her career has been shaped by adaptability and changing circumstances. “I started in Civil Engineering school because I loved mathematics and liked construction very much. But I was living in Brazil, and the country was going through a period of economical stagnation, with lack of job opportunities in this field. So, I decided to move to medicine. The next year, I took the tests again and was approved for medical school. I was 18 years old when I entered medical school in Brazil,” she recalls.
However, it wasn’t just the switch from engineering to medicine that defined her career; it was the way she viewed the field of medicine itself. Early in her medical training, Dr. Luciana da Silva noticed a disconnect between what she was diagnosing and the treatments effectiveness. She wasn’t particularly drawn to the clinical area because it often took a long time to see results, and sometimes patients didn’t comply with the treatment plans, which left her feeling disappointed.
At that point, Dr. Luciana da Silva made a decisive turn toward surgery, seeking a faster-paced, more immediate approach to patient care. Her decision would soon lead her down a path where every moment could change the trajectory of a young life.
Discovering a Passion for Heart Surgery
It wasn’t long before Dr. Luciana da Silva discovered her true passion within the world of surgery—heart surgery. The pivotal moment came when she observed her first heart surgery during medical school. “One of our teachers invited me to follow his private schedule in another hospital. I began following his work in the OR and emergency room, and that’s when I realized that’s what I wanted to do. At that hospital, I saw my first heart operation,” she shares.
The more Dr. Luciana da Silva observed, the more captivated she became, particularly by congenital heart surgery. “I truly fell in love with heart surgery, especially congenital heart surgery,” she says with palpable enthusiasm. But even as she fell deeper into her passion for heart surgery, she encountered challenges along the way. “One of my teachers casually said this was an area for men and suggested I pursue cardiology because there were more women. But I said no, I really like surgery, and I would do heart surgery.”
Determined to pursue her dream, Dr. Luciana da Silva applied for a residency in cardiothoracic surgery and was accepted. She has never looked back since, subsequently finishing a specialization in congenital heart surgery and later achieving a doctoral degree in cardiothoracic surgery at the Federal University of Sao Paulo.
Joining UPMC and Advancing Treatment for Ebstein’s Anomaly
In the years following her residency, Dr. Luciana da Silva and her husband—who is also a heart surgeon—were invited to UPMC Children’s Hospital of Pittsburgh by Dr. Victor Morell. Their expertise in a novel surgical procedure for Ebstein’s anomaly, a rare congenital heart defect, had caught the attention of the hospital. The couple had developed a specialized procedure called the Cone repair for treating this condition in Brazil, and UPMC offered them the opportunity to further advance their work in the United States.
“Here, we found a place full of people with a very high level of knowledge, especially in the treatment of congenital heart diseases. All the specialties here are very well developed, and we have all the instruments we need to further develop our field of interest,” she explains. The decision to move to Pittsburgh was a turning point in their careers. At UPMC, they were able to take their research and clinical practices to new heights, particularly in the treatment of Ebstein’s anomaly.
Ebstein’s anomaly involves the displacement of the tricuspid valve inside the right ventricle muscle, with enlargement of the right ventricle and right atrium. Due to involvement of the right ventricle myocardium, this condition can lead to severe complications such as right heart failure and arrhythmias. She was assisting Dr. Jose Pedro da Silva, her husband, when the groundbreaking technique for treating this complex condition, the “Cone repair” was created in 1993, in Sao Paulo. Together, they expanded its use to challenging situations, including the Cone repair after Tricuspid valve replacement and performing the first Cone repair after the Starnes procedure in 2019 at UPMC Children’s Hospital of Pittsburgh, a staged approach that revolutionized the treatment of critical ill neonates with Ebstein’s anomaly.
“At UPMC alone, we’ve done more than 150 cases since 2016. Here, we found strong support from the entire team. The Dr. Luciana da Silva Center for Ebstein’s Anomaly was created, integrating specialties like advanced cardiac imaging, fetal medicine, interventional cardiology, adult congenital heart disease and electrophysiology—all in one place,” she shares. This collaborative environment has allowed them to not only refine existing techniques but also push the boundaries of medical research to better understand the disease and improve patient outcomes.
Balancing Innovation and Patient Risk
As a leading surgeon in a highly specialized field, Dr. Luciana da Silva faces the ever-present challenge of balancing clinical innovation with patient safety. “In 2019, we performed the first staged treatment on a newborn with Ebstein’s anomaly that was severely sick, applying the Starnes procedure, followed few months later by the Cone repair. What we did was to sequentially combine the two well-known techniques to improve patient survival,” she explains. The goal, she emphasizes, is not only to create entirely new procedures but to enhance existing ones to ensure the best possible outcomes for patients.
The combination of the cone and Starnes procedures represents a carefully considered evolution of previous treatments. “The Starnes procedure is a simpler and reproducible technique that rescues the newborn from a critical condition, but it would commit the patient to single ventricle pathway, with possible severe complications in long term. We changed this concept by removing the Starnes patch later on and rehabilitating the right ventricle, applying the Cone repair in the tricuspid valve. The Cone repair is a complex procedure that few specialized centers have expertise and achieve good results. We have been successful in all the cases we have proposed this approach” she says. For her, patient education is paramount. By ensuring that families fully understand the risks and benefits of the treatment plan, Dr. Luciana da Silva builds trust and confidence, allowing for more informed decisions in the high-stakes environment of congenital heart surgery.
The Power of Cross-Disciplinary Collaboration
One of the key reasons for Dr. da Silva’s success at UPMC is the hospital’s emphasis on cross-disciplinary collaboration. She and her colleagues work closely with specialists across multiple fields, including interventional cardiology, electrophysiology, and research. This collaborative approach extends beyond just patient care. Her team also conducts groundbreaking research to further understand the long-term effects of congenital heart conditions and refine surgical techniques.
“We can also collaborate with nearby academic institutions like the University of Pittsburgh and Carnegie Mellon. If we have an idea, we can work with engineering departments to create new equipment. These would first be tested in animals before using in humans,” she explains. This type of interdisciplinary work is helping push the field of congenital heart surgery forward, ensuring that UPMC remains at the cutting edge of both clinical practice and innovation.
Staying Ahead in a Fast-Evolving Field
The world of heart surgery is constantly evolving, and staying at the forefront of new research, technology, and techniques is no easy task. “Artificial intelligence is evolving, but for congenital heart disease, we don’t yet apply AI to help inside the operative field, however it improves the diagnosis, treatment planning and risk assessment,” Dr. Luciana da Silva notes. And she remains committed to integrating the latest technology into her practice. UPMC uses advanced imaging equipment to create 3D-printed models of patients’ hearts, enabling surgeons to better understand complex anatomy before operating.
“We can also use 3D glasses to virtually navigate inside the heart, improving understanding for complex cases,” she adds. This innovative use of technology is helping her and her team tackle some of the most challenging surgeries, offering a level of precision that wasn’t possible just a few years ago.
The Challenges of Innovation and Training the Next Generation
While Dr. da Silva’s work continues to impact the lives of countless children, she faces significant challenges in her role. “The main challenge is time and personnel. A surgeon is like an artist—especially in congenital heart surgery. Everybody has a limited period of active life. We need to teach the next generation, but it’s like teaching someone to paint, people have different skills and style” she explains. Training new surgeons to handle the intricacies of congenital heart surgery is a long and intensive process that requires years of dedication.
“Congenital cases are complex and rare. First, we need to centralize these cases in specialized centers—like we did with Ebstein’s anomaly. Few centers in the world have done as many surgeries as we have, and our results are distinguishable,” she says. This centralization ensures that new surgeons receive the best possible training while also guaranteeing that patients have access to the highest level of care.
Mentoring Future Leaders in Heart Surgery
When it comes to mentoring the next generation of heart surgeons, Dr. Luciana da Silva places a strong emphasis on character and interpersonal skills. “First, honesty, with themselves and with patients. They must have real dedication to this life. It’s not just about operating on a heart, it’s about interacting with the child and their parents,” she says. In her view, the ability to form strong, empathetic relationships with both patients and colleagues is essential to success in this demanding field.
“Good relationships are key—with families and with colleagues. No one can be a good surgeon alone. We rely on anesthesiologists, nurses, intensivists—an entire team. You can be very smart and skilled, but if you can’t relate to others, heart surgery is not the right field.”
Shaping the Future of Heart Surgery
Looking ahead, Dr. Luciana da Silva envisions UPMC playing a significant role in shaping the future of heart surgery. “We’re receiving patients from all over—Europe and Asia—because our center offers comprehensive care and follow-up. We want to better understand the right ventricular function and whether earlier surgery could prevent dysfunction later,” she says. Through international collaborations and continued research, UPMC aims to further refine surgical techniques and offer hope to even more patients around the world.
Dr. Luciana da Silva’s work continues to have a far-reaching impact, not only through her surgical expertise but also through her leadership in advancing the field of congenital heart surgery. Being committed to improving patient outcomes and mentoring the next generation of surgeons, she remains a driving force in the world of pediatric heart care.
