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Monday, August 20, 2018

A Groundbreaking Alternative to Open-Heart Surgery

Posted By: Advancing Care

Maria Fareri Children’s Hospital offers an innovative cardiac procedure that speeds recovery.

By Debra Bresnan

For parents of children with serious heart defects, the prospect of open-heart surgery can be agonizing. To access the heart, the surgeon must open the child’s chest by sawing through the breastbone, a procedure known as a sternotomy. Then, following the surgical repair of the heart, the breastbone is reconnected with surgical wires, and the chest is closed.

However, for families across the New York metro area, a groundbreaking new option is available. Khanh Nguyen, MD, Chief of Pediatric Cardiac Surgery at Maria Fareri Children’s Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), uses a unique, less invasive and less traumatic surgical technique.

Dr. Nguyen accesses the patient’s heart through the right side (a transverse axillary incision) rather than splitting the breastbone. This unique procedure leaves only a nearly invisible scar, and unlike other thoracotomies (chest-wall incisions), spares the muscles and reduces recovery time significantly, sending children home as early as one day after surgery. While patients who underwent a sternotomy may have to wait a few months for the breastbone to heal, the right axillary incision enables young patients to resume athletic activities within a few weeks.

“We’re able to use this approach in patients ranging from infants up to adults in their 60s or older,” says Dr. Nguyen.

“I can repair a broad range of congenital heart malformations using this unique approach, and patients are able to go home and recover quickly,” he says. “Children who have congenital heart disease now have an option for heart surgery that doesn’t leave a visible scar on their chest. This procedure is truly setting a new standard, and Maria Fareri Children’s Hospital is the only pediatric cardiac center in the country that offers the transverse axillary incision.”

Dr. Nguyen has performed this groundbreaking surgical procedure on more than 500 patients since 2005. Three young patients ­­diagnosed with atrial septal defect or ventricular septal defect, more commonly known as “a hole in the heart,” recently received the surgery at Maria Fareri Children’s Hospital. Dr. Nguyen’s fast-tracking protocols allowed the patients to go home two to three days after surgery – and all three resumed normal activities within three weeks.

Robert Roseboro is happy to be back on the basketball court, showing off his skills to his mom and dad. Photo By Toshi Tasaki

Orianna Beauvais, now 3, was diagnosed in utero with a congenital heart defect. Her mom, Becky, and dad, James, of Pearl River, consulted with surgeons who wanted to perform open-heart surgery. Then, they met with Dr. Nguyen. “He explained how the procedure would be done and what benefits this approach offers,” recalls Becky. “We felt very comfortable.”

Following her surgery, in February 2018, Orianna’s parents marveled at her quick recovery. “The day after we went home from the hospital, she was a vibrant little girl, like nothing had happened,” Becky explains. “She’s full of energy, and when she’s hungry, she grabs a snack. Before her surgery, we had to put food in front of her, and she wasn’t gaining weight.”

Orianna — whom Becky describes as “a girly-girl who loves makeup, dress-up and pretending she’s a ballerina or a teacher” — is very excited to start her new daycare program. “We were very grateful for the care we received at Maria Fareri Children’s Hospital,” says Becky. “Everyone was amazing and really catered to us. They even invited us to a big reunion celebration at the hospital for former pediatric heart patients.”

When Bryce Kelley was born on November 13, 2017, a heart murmur raised red flags. An electrocardiogram revealed a hole in her heart, and her parents, Erin and Mike, of Beacon, took her for regular follow-up appointments with a cardiologist every two weeks. On March 20, 2018, after Bryce reached 10 pounds, Dr. Nguyen performed surgery. “We were in total shock and a little scared,” says Erin. “She was very thin; her hands and feet were always cold; you could feel her heart beating very fast. She slept a lot after feedings because her body was working so hard to stay alive.”

Bryce came home on the second day after her surgery with a 2-inch incision under her arm. “Now, she’s a totally different baby,” says Erin. “Her cheeks, arms and legs are chubby. It’s amazing.”

Khanh Nguyen, MD, Mike and Erin Kelley with baby Bryce, Ana Riccio, PA, and John Carleson, PA. Phot oBy Duvell campbell/WMCHealth

Before the surgery, she took medications to reduce the volume of liquid in her heart, but she no longer needs them. “The shock of getting bad news about your baby is eye-opening,” says Mike. “We were anxious about her weight, and the worst part was being unable to help her. We looked forward to the surgery because we knew it was what she needed. The staff at Maria Fareri Children’s Hospital was very friendly and knowledgeable.”

“We felt very taken care of and knew she was in good hands and that they would help her no matter what,” says Erin. “Deciding to have this surgery was an easy choice, because we felt very reassured with Dr. Nguyen.”

Robert Roseboro, 14, of Yonkers, was born prematurely, with a hole in his heart, yet he never had serious symptoms until recently. He felt tired, and his “heart hurt,” even when he wasn’t running. Dr. Nguyen determined his heart was enlarged and that a faulty valve was impeding his ability to function. Robert’s parents, Hazel and Robert, were concerned because Robert Sr.’s own recovery from open-heart surgery as an adult had taken four months.

Dr. Nguyen performed surgery in February 2018. “We’re so pleased with the outcome,” says Hazel. “Robert finished eighth grade and went on vacation to a Disney World water park in June. He has a wicked sense of humor, plays basketball and is exceptionally kind and caring. His teachers think he’s very bright, and he’s active in his church youth group.Seeing him smile, laugh and connect with people again has been tremendous. It’s very isolating for a young person to deal with a serious health issue, but he’s definitely back to himself. He has more energy and stamina and has grown about an inch since the surgery.”

“The quality of care at Maria Fareri Children’s Hospital is exceptional, and they give that excellent care to every family that walks through the door,” says Hazel. “This is where you should get care for your child.”  

Cardiac Care at WMCHealth

Westchester Medical Center 914.909.6900

Maria Fareri Children’s Hospital 914.493.8372

MidHudson Regional Hospital 845.483.5720

Good Samaritan Hospital 845.368.5620

St. Anthony Community Hospital 845.987.5147

HealthAlliance Hospitals 845.210.5600

Main Photo By Teresa Horgan