Singing in a choir strengthens breathing capacity, decreases depression and anxiety, and improves perceived school functioning in children born with a single heart ventricle, according to a feasibility study from Ann & Robert H. Lurie Children's Hospital of Chicago published in Pediatric Cardiology . This intervention, including in-person and online singing and breathing instruction, was developed and trialed in collaboration with Northwestern University Bienen School of Music.
Children born with a single ventricle face physical and psychosocial challenges related to the three surgeries they undergo, ending with the Fontan procedure when they are around 3-4 years old. Over the course of these three surgeries, surgeons reroute oxygen-poor blood from the upper and lower body and connect it directly into the pulmonary artery, bypassing the heart completely. This allows blood to flow passively to the lungs, driven by normal breathing and pressure changes rather than a heart pump.
While lifesaving, the surgeries may result in weaker lungs. Affected children often have decreased exercise tolerance, tiring easily with activity. Over time, the passive blood flow to the lungs can contribute to heart failure and may lead to the need for a heart transplant. Many of these children have neurocognitive differences, such as ADHD, also as a consequence of their single ventricle heart disease.
"We offered our Fontan patients participation in the choir in hopes to provide a fun way to support their lungs and psychosocial development," said lead author Kendra Ward, MD, MSCI , Director of Cardiopulmonary Exercise Lab and Cardiac Rehabilitation Program at Lurie Children's, and Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "We found that the kids really enjoyed it. Many expressed that the choir gave them a sense of camaraderie and helped them feel less alone. I underappreciated to what extent these kids felt different from their peers."
The choir included 14 patients, aged 8-16 years, who participated in the program for eight weeks. The study provided 30 minutes of private voice instruction and 60 minutes of group instruction a week. Participants also had access to an online program of singing and breathing exercises.
Post-intervention assessments demonstrated improvements in some breathing measures, and higher scores on self-reports of depression and wellbeing, as well as parent reports of school function, depression and anxiety.
"We hope to launch a larger, multicenter study of the choir intervention in 2027," said Dr. Ward. "We also are starting a non-study choir this fall, since the kids and families wanted to keep it going. In the future, we'd like to branch out and include children with congenital heart disease who have other diagnoses. We are excited to benefit more children with this novel program that does not require significant resources and could be replicated anywhere."
Ann & Robert H. Lurie Children's Hospital of Chicago is a nonprofit organization committed to providing access to exceptional care for every child. It is the only independent, research-driven children's hospital in Illinois and one of less than 35 nationally. This is where the top doctors go to train, practice pediatric medicine, teach, advocate, research and stay up to date on the latest treatments. Exclusively focused on children, all Lurie Children's resources are devoted to serving their needs. Research at Lurie Children's is conducted through Stanley Manne Children's Research Institute, which is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children's is the pediatric training ground for Northwestern University Feinberg School of Medicine. It is ranked as one of the nation's top children's hospitals by U.S. News & World Report.
