Timely Intervention Repairs a Tiny Heart
When Julian was a year old, his pediatrician detected a heart murmur during a well-visit and referred him to a cardiologist. After testing, the cardiologist diagnosed Julian with an Atrial Septal Defect (ASD) and told his family he might need cardiac catheterization or heart surgery around age three if the defect didn’t close spontaneously as he grew.
Although some ASDs are found before or soon after a child is born, others may not be found until later in life. ASDs happen during the fetal development of the heart. In an ASD, there's an opening in the wall (septum) between the atria. As a result, some oxygenated blood from the left atrium flows through the hole in the septum into the right atrium, mixing with oxygen-poor blood and increasing the total amount of blood that flows toward the lungs. The condition increased blood flow to Julian’s lungs, creating a swishing sound called a heart murmur.
“At his checkup when he was just two and a half years old, the cardiologist said Julian would need a procedure soon to close the ASD and that we should select a hospital for the surgery,” mom Maria recalled. “He discussed two hospitals close to home and said St. Christopher’s Hospital was one of the best hospitals for pediatric surgery and cardiology. We chose St. Christopher’s Heart Center.”
The cardiologist referred Julian to Mohammed S. Ghanamah, MD, Chief, Section of Cardiothoracic Surgery at St. Christopher’s, who specializes in the surgical treatment of congenital heart conditions. That same day, a St. Christopher’s Heart Center staff member called Maria to set up an appointment quickly.
“Everything happened very fast,” Maria said. “His cardiologist wanted to get us in quickly, and St. Christopher’s gave us an appointment in a week and a half. Our first visit was with Dr. Ghanamah. He was very thorough, explaining the type of surgery, what it would look like for Julian and the family, and whether he may need additional surgery. Dr. Ghanamah explained everything to us, including the risks, and let us know Julian would be fine in the future. He was very comforting. We were very worried about surgery because my son is not very big.”
Dr. Ghanamah and his team performed an atrial septal defect repair using Julian’s pericardium as a patch. As the surgery progressed, Dr. Ghanamah discovered that the defect was very close to some of the pulmonary (lung) veins which made the repair more technically challenging. He was able to repair everything and the surgery was a success.
“After the surgery, the surgical team came to the waiting room and explained everything that had happened and what the next steps would be,” Maria said. “They made sure I was a part of every discussion about Julian’s care. I wanted to hear everything, and they allowed me to participate 100%.” Following surgery, Julian was transported to the pediatric intensive care unit (PICU).
St. Christopher’s Heart Center and PICU feature qualified, board-certified physicians, nurses, advanced practice providers, medical assistants, technicians, and other support personnel working together to care for each patient. During his stay in the PICU, Julian was treated by Maria P. Bergel, MD, who specializes in pediatric critical care medicine, and Boban P. Abraham, MD, a pediatric cardiologist. Team members met with mom Maria several times a day as Julian recovered and answered her questions. "Any time I wanted to speak to anyone, they were right there,” Maria said.
ASD closure is usually safe and effective, but it does carry some risks and complications, including blood clots, strokes, and an abnormal heart rhythm called an arrhythmia.
Julian spent a week in the PICU recovering. During his stay, Julian’s favorite PICU nurse, Nick, detected a blood clot and quickly called in Dr. Bergel. “Dr. Bergel knew what was needed for Julian to get better and acted fast. She made sure I understood everything that was happening, which I really appreciated.”
“It is amazing what Dr. Ghanamah does and what everyone at the hospital does,” Maria added. “Nurse Nick was also amazing, and my son loved him from the moment they met. My son was adamant about who he wanted around him and just took to Nick. Dr. Bergel was wonderful to Julian in the few days we had her, and so was Dr. Abraham. My experience at St. Christopher’s was one of the best experiences I could have hoped for during a challenging time for our family; everyone was very helpful, from the surgeon to the nurse to other staff. I will never forget their help, care, and everything they did for Julian.”
Julian was just cleared by his cardiologist and celebrated his third birthday. Mom says he adjusted quickly at home following surgery and is thriving.