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Open-Heart Surgery Saves Day-Old Infant

February 2001 — Each time Ahmad lets out a hearty scream, his mother knows she has been blessed. They've come a long way from December 15, when the baby was born at Memorial Hospital West with complications that left him too weak to whimper. Less than 24 hours later, a complex open heart operation performed by Dr. Richard Perryman, Chief of Pediatric Cardiac Surgery at Joe DiMaggio Children's Hospital, put Ahmad on the road to good health. Ahmad was born with four defects in a heart the size of a walnut. The syndrome, called Tetralogy of Fallot, occurs in about 50 out of 100,000 infants, and is marked by a deformed or missing pulmonary valve; a hole between the two lower chambers of the heart (ventricular septal defect); a thickened right ventricle and a displaced aorta. As a result, the blood circulating through the body contains insufficient oxygen, and babies appear blue, particularly when they exert themselves. The defect also caused Ahmad's arteries to grow abnormally large and soft, making breathing difficult.

Ahmad and Family

These serious problems were a terrible shock to the baby's parents, Lashonda and Fred . Lashonda had taken good care of herself during her pregnancy, and her routine ultrasounds were completely normal. "The last thing we expected was a heart defect. We could see his little hands and feet on the ultrasound and they told us everything looked fine. They didn't pick up the defect because the baby was getting plenty of oxygen through my umbilical cord," she explains.

While some children with heart defects can wait months or years before having them repaired, Ahmad needed a lifesaving operation as soon as possible. Before Lashonda could hold her long-awaited baby in her arms, he was transferred to Joe DiMaggio Children's Hospital and whisked into the operating room. There, Dr. Perryman opened the baby's tiny chest and inserted a new pulmonary valve fashioned from donated heart tissue. He closed the hole between the two pumping chambers, opened an area of muscular obstruction, and tailored down the arteries to their proper size to ensure adequate blood flow.

The unexpected turn of events was a bitter pill for the stressed parents to swallow. "I didn't think he was going to make it," says Lashonda, who was still recovering from labor and trying to come to terms with Ahmad's complications when he was taken into surgery.

A Leader in Open-Heart Procedures

Fortunately, the baby was in excellent hands: Dr. Perryman has done thousands of operations like Ahmad's in his career. He built an international reputation as chief of cardiac surgery and former director of pediatric cardiac surgery at the University of Miami/Jackson Memorial Hospital before joining Memorial Regional Cardiac and Vascular Institute / Joe DiMaggio Children's Hospital in 1998.

"As a congenital disease surgeon, I put my skills to use regularly in children and adults with heart defects. I am accustomed to taking the heart apart and putting it back together," he explains.

Because of the diverse talents of Perryman and other members of the team, Memorial Regional Cardiac and Vascular Institute has become a leader in open-heart procedures in people of all ages, attracting patients from as far away as the Northeast and also the Caribbean and South America.

"All the pieces for taking care of critically ill children are in place here: pediatric cardiologists and cardiac surgeons, full-time pediatric intensive care specialists, experienced pediatric anesthesiologists and a pediatric ICU with skilled nursing," says Dr. Perryman.

Ahmad's Homecoming

For four weeks after the operation, Ahmad remained in the PICU while his parents, who live in Miami, took up residence at the Conine Clubhouse across the street. This enabled them to stay as much as possible at their baby's side. When Ahmad was discharged on January 15, the parents rejoiced. "I can't express it in words what it feels like to be taking my son home. If you could open up my heart, then you would truly know how I feel," she says.

Since that day, the little guy his father calls "the Champ" has continued to gain weight and strength. Although his new pulmonary valve will probably need to be replaced with a more permanent one next year, his parents are relishing every moment with their now healthy baby boy.

Lashonda is still looking for the right words to write a letter of thanks to Dr. Perryman, the PICU staff and everyone else who cared for them at Joe DiMaggio Children's Hospital. Meanwhile, a poem that comes straight from the heart says it best: