A Mended Heart

Laney 2

It was four minutes before closing time at the CHKD Urgent Care at Loehmann’s Plaza when Stephanie and Chris Lyon rushed in with their 7-day-old daughter, Laney.

“She hadn’t been eating well,” says Stephanie. “And that night, I noticed her arms and legs felt cold, and her cry was unlike any baby cry I’d heard before.”

A registration tech, recognizing how sick the baby was, immediately called for the charge nurse. Within minutes of her arrival, Laney was receiving the lifesaving care she needed.

“Laney’s breathing was shallow, and her skin looked gray. Her circulation was poor,” says Dr. Usama Samaan, the urgent care physician on duty that night. “She was critically ill. We knew we had to act quickly.”

The urgent care medical team called 911 and began work to stabilize the baby by giving her oxygen, starting an IV line and closely monitoring her vital signs. Minutes later, Virginia Beach paramedics arrived and inserted a breathing tube to maintain Laney’s airway until the CHKD transport team could take over her care and deliver her to the hospital.

Each CHKD transport vehicle is a fully equipped intensive care unit staffed with a three-person team including a paramedic, a pediatric critical care nurse and a pediatric respiratory therapist.

When the transport team got to urgent care that night, they found a baby barely clinging to life. “She was very pale and cold and had no muscle tone,” says Karen Callaway, the team’s nurse. “She was blue around the mouth, and I couldn’t feel a pulse in her extremities. Her heart was beating, but it wasn’t supplying enough oxygenated blood to her body.”

Intraosseous infusion (IO) lines were started to provide medication and fluids to further assist in stabilizing Laney’s vital signs. IO is the process of injecting directly into the marrow of the bone and is used during critical emergencies when intravenous (IV) access is not enough. The transport team was also in communication with pediatric emergency medicine specialist Dr. Nicolas White and pediatric critical care specialist Dr. Robert Gomez, who prepared for the baby’s arrival at CHKD.

“When a week-old baby has a sudden, disastrous illness, a heart problem is among the handful of conditions that top the list of possibilities,” Dr. Gomez says. “But you can’t be certain until you have your hands on the patient.”

When Laney arrived, an ultrasound revealed that she was suffering from multiple congenital heart defects. It was 4 o’clock in the morning when Dr. Lopa Hartke, a CHKD pediatric cardiologist, met with Stephanie and Chris to explain that their baby would need emergency heart surgery.

“It’s difficult news for parents to hear,” says Dr. Hartke. “The details are often lost in those stressful moments.” She drew a picture of Laney’s heart so that they would have a better understanding of what was wrong. Laney’s heart had two holes, one between the lower chambers and one between the upper chambers, along with a very narrow aorta, the main artery supplying oxygenated blood to her body.

“Her blood was, in a sense, backing up because of the narrowing in her aorta” says Dr. Hartke. “Because her tissues were not receiving needed blood flow and oxygen, she went into shock and had an overproduction of acid in her blood. The good news was that these were repairable issues, often with good long-term outcomes.”

At that time, CHKD’s heart center was in the early stages of a partnership with UVA Children’s Hospital, a plan in which Dr. James Gangemi, chief of congenital heart surgery at UVA, would lead a collaboration between the two programs. Laney’s procedure would be Dr. Gangemi’s first surgery at CHKD.

“The goal of this partnership is to optimize the care of pediatric cardiac patients throughout the state, whether through surgery or other intervention,” Dr. Gangemi says. “We truly believe this collaboration is the wave of the future and want it to be a model for other states.”

Laney’s body temperature was lowered to 70 degrees, and her heart was put on bypass while Dr. Gangemi, working with CHKD’s cardiac surgery team, spent the next three hours repairing the holes in her heart and reconstructing her aorta. Once the surgery was complete, Laney’s heart was restarted, and her body temperature was slowly brought back to normal. The complete procedure lasted five hours.

After surgery, Laney spent 14 days recovering in the CHKD pediatric intensive care unit. “Because of all of the IV lines and tubes Laney had while she was in the PICU after surgery, I was unable to hold her,” Stephanie says. “Those were the longest days of my life.”

Laney 1Since then, Laney has grown into a healthy, active toddler. And Stephanie’s desire to give back to CHKD has grown as well. Almost a decade earlier, Stephanie had become active with the Virginia Beach City Union of The King’s Daughters and had even planned to take over as the group’s president shortly after Laney’s birth. But now she has embraced an unexpected role as she speaks about her family’s CHKD story at many events, often with husband Chris at her side.

“At first, I told our story for selfish reasons,” Stephanie says. “It was cathartic. But as time has passed, this has become a crusade for me. I have the utmost gratitude for every person at CHKD. I believe, as a community, we can all help ensure that every baby like Laney will have the expert care they need.”

The heart specialists at UVA and CHKD are working together to do just that. Since Laney’s surgery, the program has expanded to include an additional pediatric cardiac surgeon, Dr. Philip Smith.

“This partnership is a unique opportunity to build on the strengths of our respective organizations by coming together to help more children get the heart care they desperately need – at the right time and in the right place,” says Jim Dahling, president and CEO of CHKD Health System.

Laney is proof positive the collaboration is a success as she bounds about her parents’ Virginia Beach home, playfully rough-housing with her older sisters Holly and Tori. A fading scar on her chest is all that remains of the critical illness she has overcome. 

This story appeared in the Winter 2018 edition of Kidstuff magazine, a quarterly publication from CHKD that features inspiring stories about patients, families, physicians and friends of CHKD.