For the first time in nine weeks, Angel can breathe freely with his own heart, without being attached to the octopuslike lines of plastic tubing and pumps that had kept him alive.
The 2-year-old, who is being treated at Seattle’s Children’s Hospital and Regional Medical Center, on Wednesday night received the heart transplant he had been waiting for, the new heart he needed to save his life.
It was the last, and biggest, step in the toddler’s medical saga, which began in January when he was admitted to the hospital critically ill from a failing heart.
He was diagnosed with cardiomyopathy, an enlarged heart often caused by a virus. It significantly weakens the heart’s ability to pump blood throughout the body.
“I’m thrilled; it feels good,” Dr. Gordon Cohen, who performed the transplant surgery, said Thursday.
“You go out on a bit of a limb when you decide to do something like this and you want a good outcome,” he said. “It looks like we’re going to.”
The calculated risk Cohen was referring to was the decision to hook Angel up to a mechanical heart. That history-making operation took place Feb. 7 and made Angel the first child younger than 5 in the Pacific Northwest – and one of only 60 children in the United States – to receive a mechanical heart.
Although the heart pump has been used on both children and adults in Europe, its German manufacturer has not yet received approval for the device to be regularly used in the United States. So it took a special emergency request to the federal Food and Drug Administration for Angel to receive approval to get the mechanical pump, called a Berlin Heart.
“His parents were courageous for letting us go forward with this,” Cohen said. “In the end, it will make a difference for him and for other kids.”
Angel’s parents allowed the hospital to publicly discuss the details of his treatment, and a story of Angel’s treatment and his wait for a transplant was published in The Herald on March 11. However, his parents did not want other personal details disclosed, such as their son’s last name, their names, and their hometown and state.
“He’s stable,” Cohen said. “I think anybody who has a transplant, you’d have to say is critically ill, but stable. I would anticipate he’s going to have a steady and continuous recovery.”
Wednesday’s operation began with a middle-of-the-night phone call alerting Cohen to the possibility that a donated heart might be a match for Angel.
“Not every organ offered is a good one,” Cohen said. “So we have to make an evaluation (with) back-and-forth phone calls.”
Once the decision was made to go ahead, a team was sent to retrieve the donated heart. Cohen declined to give any details, including the state or even the region of the country the donated heart came from.
In Angel’s case, the transplant process was unusually complicated. First, surgeons had to unhook Angel from his mechanical heart.
The actual pump, about the size of a peach, is mostly made of clear plastic. It works with a patient’s own heart, which remains in place until a transplant is found.
“Without that heart, he couldn’t have survived,” said hospital spokeswoman Jennifer Seymour.
But tubing from the pump to the patient’s heart caused an unusually large buildup of scar tissue. Surgeons had to carefully cut it away. “That took hours,” Cohen said.
Once the Berlin Heart was unhooked, Angel was hooked to a heart-lung bypass machine until the transplant arrived. Surgeons then removed Angel’s own heart and sewed the new heart into place.
Surgeons finished up about 8:30 p.m. “The transplant took basically all day,” Cohen said.
The first 72 hours following surgery are critical, Cohen said.
Angel’s recovery will be at a slower pace than that of adults receiving a heart transplant. Adults wake up and understand what has happened to them, he said. “We make sure kids are comfortable and not in pain or confused or scared.”
“That’s why we have to keep them sedated and see that everything’s OK, and then we wake them up.”
As of Thursday evening, Angel’s condition was described as critical, as is typical for heart transplant patients in the first days following their surgery.
He is expected to remain in the hospital’s intensive care unit for about a week and remain hospitalized for perhaps several weeks after that.
Meanwhile, the wait continues for two other children under 18 in the Northwest who need new hearts, too.
The unbending rule of organ donation is that one person has to die in order for another to live.
“We can’t get rid of tragedy,” Cohen said. “We can help to reduce other tragedies with organ donation and organ sharing.
“It’s of critical importance,” he said. “You can see it in a kid like this.”
Reporter Sharon Salyer: 425-339-3486 or salyer@heraldnet.com.
Talk to us
> Give us your news tips.
> Send us a letter to the editor.
> More Herald contact information.
