JAMM AQUINO / JAQUINO@STARBULLETIN.COM
Melissa and Nicoles Piotrowski had their baby boy, Iden, on May 20 in San Diego. They had to fly there after doctors at Kapiolani discovered in a fetal echocardiogram that their baby's blood vessels were reversed to the heart, requiring special open-heart surgery.
Rare surgery saves baby
An infant's heart defect requires a special procedure in California
Two-month-old Iden Piotrowski is gaining weight and doing fine after his birth and lifesaving surgery in San Diego.
His parents, Marissa and Nicoles, are still recovering from the frightening events surrounding their first child's start in the world.
"They had to do open-heart surgery for the baby, and it was really scary for me and my husband," said the new mother.
Piotrowski said she was 10 days past her due date for delivery when doctors discovered the unborn baby had a complex congenital heart defect requiring surgery that is not done in Hawaii.
"The pump itself, the heart, is normal, but arteries coming out of the heart were switched," said Dr. James Sim, pediatric cardiologist at Kapiolani Medical Center for Women & Children. Without surgery to switch them back, the baby would die, he said.
Roughly 1 percent of all births have a congenital heart defect, and about 5 percent involve transposition of arteries, Sim said.
Newborn open-heart surgery is not done at Kapiolani, so the doctors recommended that Piotrowski deliver on the mainland, he said.
"We had to fly right away to San Diego," she said. "I was already at 39 weeks. We didn't know if they were going to let me fly on the plane. We tried and booked a ticket, and they gave me a shot at Kapiolani so I was not going to go into labor."
Iden was born May 20 at Sharp Mary Birch Hospital and was immediately transferred to the Rady Children's Hospital for corrective surgery by Dr. John Lamberti, director of pediatric surgery there.
The renowned pediatric cardiac surgeon comes to Hawaii about five times a year to assist on Kapiolani's complicated pediatric cardiac cases.
He said in an e-mail that Dr. Howard El Said used a balloon catheter to enlarge the opening between the upper chambers of the baby's heart, and Lamberti performed surgery May 24 on the 4-day-old baby.
Marissa said her husband went with the baby to Children's Hospital because she was still recovering from the delivery at Sharp Mary Birch Hospital. But her doctor allowed her to go to Children's Hospital for the baby's surgery, she said. "The worst part of it was the day that we find out (results of the surgery), because we don't know what's going to happen."
The aorta, the large blood vessel providing blood flow to the baby's body, and the pulmonary artery, the large blood vessel delivering blood to the lungs, were correctly attached in the operation, Lamberti explained. The coronary arteries also were "reimplanted," he said.
Iden was in the hospital's neonatal intensive care unit, and his mother stayed at the Ronald McDonald House there until returning to their Mililani home June 24. Her husband, a field engineer at Lockheed Martin, had to return earlier, she said.
Marissa, 34, supervisor at the food court at Schofield Barracks, said Dr. Richard Oh, her obstetrician-gynecologist, had referred her to Kapiolani because she has uterine fibroids, making her pregnancy high risk.
She was going to Kapiolani twice a week for prenatal checkups. "Then 10 days beyond my due date, they were doing ultrasound, and they found something wrong with the baby's heart." Dr. George Graham, obstetrician-gynecologist in the fetal diagnostic unit, picked up the heart defect, and Sim performed a fetal echocardiogram confirming that the great arteries coming out of the baby's heart were reversed.
Lamberti said, "This means that oxygenated blood from the lungs is not delivered to the baby."
"This congenital heart defect is severe and life-threatening but generally treatable" with open-heart surgery during the first week of life, Lamberti said.
Iden, who weighed 8 pounds, 6 ounces at birth, was 12 pounds earlier this month, Piotrowski said.
"He looks great," Sim said. "He's going to be fine."
Wednesday, August 6, 2008
Nicoles Piotrowski is the father of Iden, an infant who had lifesaving heart surgery in San Diego after he was born on May 20. A photo caption on this article originally incorrectly spelled the father’s first name as Nicolas and also incorrectly said the baby was born on May 24.