A Tiny Heart
By Loretta Coureas
Identical twins Logan and Riley Haddigan were born three months early and taken immediately to CHKD’s neonatal intensive care unit.
Their parents, Alicia and Jon Haddigan, expected the twins’ early arrival. Alicia spent weeks on bed rest in hopes of giving her unborn babies a little more time to grow. During that time, the couple learned that one of the twin boys would have a heart problem that could be
corrected by the cardiologists at CHKD.
What the Virginia Beach couple didn’t expect was the twist of fate that took Riley’s life just four days after the twins were born. Riley was the twin who did not have a heart defect. His death was attributed to the phenomenon known as twin-to-twin transfusion syndrome, which sometimes – though rarely – occurs in the case of identical twins when one baby receives blood from the other in utero, weakening the “donor” twin.
“We were devastated,” Alicia and Jon said, almost in unison.
They hardly had time to say good-bye to their infant son when they learned their surviving twin’s heart condition was even more serious than first thought. The valve between his heart and his pulmonary blood vessel was more severely narrowed – “stenosed” in medical terms – than expected. Instead of a healthy gush of blood pumping between his heart and lungs, he had a trickle, too little to sustain his body’s ability to oxygenate blood.
“We were able to hold Riley only a short time when he died,” Alicia recalls, “while in a crib nearby, his brother Logan was dying because of a heart defect.”
Pediatric cardiologist Michael Vance and his partners at CHKD see probably five babies with pulmonary stenosis in a year, but few are as young and small as one-pound-five-ounce Logan. “Usually, we wait a few weeks or even months to give the baby a chance to grow and get a little stronger before we do an intervention,” Dr. Vance said, referring to a cardiac catheterization. “But we could not wait in his case.”
In order to save his life, Logan was taken to CHKD’s cardiac catheterization center just six days after he was born where he was anesthetized and Dr. Vance catheterized him.
In heart catheterizations, the cardiologist inserts a tiny wire through a vein in the groin and threads it up to the heart. “Just like in adults,” Dr. Vance explained. “But this wire and catheter are barely the size of angel hair pasta.”
Once he centered the catheter across the pulmonary valve, Dr. Vance inflated an ultra-tiny balloon to open the valve flaps, thus allowing Logan’s blood to flow to the lungs and receive life-giving oxygen.
After Logan’s cardiac procedure, the Haddigans spent long hours by their baby’s incubator in the NICU. He grew stronger and was moved to the NICU’s step-down unit several weeks later in preparation for going home.
“The staff was great every step of the way,” Alicia said. “I don’t know what it would have been like if we hadn’t had such support. His big brother, Connor, was even allowed to come visit him and touch him through the opening in the incubator.” She recalls how Dr. Vance and his physician assistant Tammy Dichiara fully explained everything and even drew pictures to illustrate the defect in Logan’s heart.
When Logan was almost 3 months old and eating well, he returned to the cath lab for a second and final procedure to open the pulmonary valve permanently. Then Logan was moved to the pediatric intensive care unit, with his parents again anguishing over their baby’s crib.
“Logan was a fighter,” Alicia recalls. She beamed as she watched the now 18-month-old toddler playing with balls and blocks and cars in the family living room. “He is perfectly normal and obviously making up for lost time.”
Dr. Vance says Logan has a clean bill of health and should progress normally without further need for cardiac repair. “He’s a great kid and should have a normal childhood,” the cardiologist said.
Twenty-five years ago, open-heart surgery was the only way to correct such heart valve problems. “On a baby as small as Logan, this would have been almost impossible back then,” Dr. Vance said. “He is one of the smallest children I have ever catheterized.”
Such miracles of modern medicine are fully appreciated by the Haddigans. Today, their red-haired son is a blaze of activity showing no signs of slowing down.
“We’re very grateful for his good health,” his mom says. “He’s even developmentally ahead of full-term babies his age. Thank goodness for CHKD and the wonderful people who work there.”
Dr. Vance practices with Children’s Specialty Group PLLC at CHKD.
This story was featured in the third 2009 issue of KidStuff, a publication of Children's Hospital of The King's Daughters.
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