"Broken" Heart Saves Little Girl

They died waiting.

In a seven-year span, 533 kids hoping for heart transplants didn't get one in time.

But one little girl's surgery could change the rules—and save more lives.

Four-year-old Kallie Finn and her daddy are two of a kind. "We're real close anyway, she's always been my little buddy," her dad, Mitch Finn said.

When Mitch was five, he had to have a heart transplant. This year, he learned Kallie's heart was failing, and she'd need one, too.

A ventricular assist device kept Kallie alive for weeks, but the clock was ticking.

"Essentially, three times as many kids die on a waiting list compared to adults," said Pirooz Eghtesady, a surgeon and Co-director of the Heart Center at St. Louis Children’s Holspital.

With that fact in mind, Kallie's cardiac surgeon made a surprising call. He decided to give her a donor heart other centers had rejected—a heart with a hole in it.

Holes in hearts are congenital defects that change the normal flow of blood through the heart. Treatment for the condition has greatly improved over the last few decades, and kids who have it can survive to adulthood.

"It was hard for me to justify throwing away really a good organ for a child who needed it,” Eghtesady said.

Kallie's surgery-went perfectly.

"Now we both have zippers!" Kallie said to her father as she prepared to head home from surgery.

Now Kallie's doctor hopes her story opens a door.

"There are probably a lot of hearts that can be used that perhaps are not used,” Eghtesady said. “And this is an opportunity to extend it cautiously to other organs that may be available."

That change would make more donor hearts available for the kids who need them most.

Kallie's doctors aren't sure if anyone has ever done a transplant using a heart with a hole in it. And, given the same situation, they say they wouldn't hesitate to use a heart with a hole, as long as it was otherwise healthy.

They're hoping other doctors will follow suit.



REPORT: MB #3386

BACKGROUND: Heart failure means the heart can't pump enough blood to meet the body's needs. As the pumping action is lost, blood may back up in other areas. Fluid builds up in the lungs, liver, gastrointestinal tract, arms and legs (congestive heart failure). Narrowed arteries in your heart or high blood pressure gradually leave your heart too weak or stiff to fill and pump efficiently. Many conditions that lead to heart failure can't be reversed, but can often be treated with good results. Lifestyle changes, such as exercising, reducing salt in your diet, managing stress, treating depression, and especially losing excess weight, can improve quality of life. The best way to prevent heart failure is to control risk factors such as coronary artery disease, high blood pressure, high cholesterol, diabetes or obesity. (www.mayoclinic.com, www.ncbi.nlm.nih.gov)

HEART TRANSPLANT: A heart transplant is surgery to remove a damaged or diseased heart and replace it with a healthy donor heart. Finding a donor heart can be difficult. The heart must be donated by someone who is brain-dead but still on life support. The donor heart must be matched as closely as possible to the damaged heart's tissue type to reduce the chance of rejection. A cut is made in the breastbone to access the heart. The patient's blood flows through a heart-lung bypass machine, while the surgeon works. The machine supplies the body with blood and oxygen while the heart is stopped.The diseased heart is removed and the donor heart is stitched in place. Tubes are inserted to drain air, fluid, and blood out of the chest for several days, allowing the lungs to fully re-expand. In some cases, the surgeon won't remove the old heart, but put the new heart on top of it. (www.nlm.nih.gov)
ST.LOUIS CHILDREN'S HOSPITAL: SLCH is the pediatric teaching hospital for Washington University School of Medicine. Founded in 1879, it is the oldest pediatric hospital west of the Mississippi River and the seventh oldest in the United States.
Established in 1986, St. Louis Children's Hospital pediatric heart transplant program has given new life to more than 327 patients, ranging in age from three days to 22 years. It is one of the most active pediatric heart transplant programs in the United States, with patients coming from as far away as Florida, Minnesota and Texas. It is nationally recognized as a leading pediatric heart transplantation center, performing 20 to 30 heart transplants each year.
In addition to being the first to transplant a heart with a hole in it, SLCH was the first hospital in the state of Missouri to implant the Berlin heart, chosen as one of 12 pediatric transplant centers in the U.S. to participate in a study with Berlin heart and the FDA. SLCH also performed the first of three successful ABO-incompatible heart transplants in 2004 by transplanting organs to infants with an unmatched donor blood type. (www.stlouischildrens.org)
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