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Other than feeding very little and sleeping a lot, Ayden Gendreau seemed perfectly normal on the first day of his life.
True, having arrived three weeks early, Ayden was a little small at 6 pounds, 4 ounces. But that was nothing serious and, besides, his mother's pre-delivery ultrasound had looked normal.
Day two changed everything.
Not only would he barely feed, but his face appeared bluish--alarming developments for his parents--Patsy and Ryan Gendreau of Independence, Iowa, and the staff at Mercy Medical Center in Cedar Rapids.
An echocardiogram quickly revealed two serious heart problems:
- A large ventricular septal defect--a hole between the pumping chambers of his walnut-size heart.
- The transposition of his great artery (his arteries were arising from the wrong pumping chambers).
Unless these defects could be fixed, Ayden would die.
While surgery is often the best option for this defect, this was a complicated case. The hole could not be reached easily using traditional surgical techniques.
Recognizing Ayden's urgent need for highly specialized care, Mercy's doctors transferred him to University of Iowa Children's Hospital.
There, heart specialists decided Ayden was an ideal candidate to become the state's first "hybrid" heart surgery patient. Ayden's hybrid team would include heart surgeons, interventional cardiologists, and echocardiographers (cardiologists specialized in heart ultrasound).
"These are specialties that normally wouldn't work together at the same time because they take differing approaches to solve different problems," explains Abhay Divekar, MD, director of the UI Cardiac Catheterization Laboratory. "We are one of only a few centers around the nation using this innovative approach."
James Davis, MD, chief of UI pediatric cardiothoracic surgery and transplantation, says hybrid heart surgery potentially reduces the risk for certain patients, depending on the treatment they need.
"By combining catheter-based interventions with less drastic surgical approaches, we can maximize patient safety," he says.
Ayden's procedure occurred Oct. 22, 2008, when he was 20 days old.
Davis and the surgery team began by creating a 3-inch incision in Ayden's chest. Divekar and Davis then placed a catheter through the wall of the heart to deliver a nickel-titanium device to the inside of the heart to plug the septal defect.
The transposition of the great arteries was then repaired using traditional surgical techniques.
The entire procedure took about eight hours.
"Except for the scar on his chest, he'll be just like any other kid on the playground," Davis says.
Ryan and Patsy Gendreau say they understood the challenge their son was facing but did not worry about the quality of care they were getting.
"This is a teaching hospital, so we expected them to have the right technology to handle the surgery," Ryan says. "They certainly did, and we feel very fortunate to have a healthy baby. It was the right place to be."
While Ayden will require regular visits to a cardiologist for the rest of his life, doctors say his future should be normal and healthy.
"He's our first-born son so we're still learning how to act like a family," Ryan says. "We truly appreciate the expert care we received."
For more information about the pediatric heart care services at UI Children's Hospital, family members should call UI Health Access at 800-777-8442.
For consultation or referral, physicians should contact UI Consult.
--Michael Sondergard
To view a video and learn more about hybrid heart surgery, visit UI Children’s Hospital Videos
"Hybrid surgery combines non-surgical interventions with less drastic surgical approaches, thereby maximizing patient safety."
--James Davis, MD |
