An echocardiogram revealed that Cienna was born with a congenital heart defect known as ventricular septal defect (VSD). “In essence, it’s a hole between the lower two chambers of the heart,” says Karl Welke, MD, a congenital cardiac surgeon at Children’s Hospital of Illinois. “The size and location of the hole varies from patient to patient.”
Minding the Gap
For some children, the hole may close on its own within the first few years of life. For others, the problem is much more serious and requires surgery because it can lead to heart failure in newborns. “The size of the hole in Cienna’s heart wasn’t exceptionally large, but the location was concerning,” Dr. Welke says. Her VSD was located near the aortic valve, which shuttles blood from the heart to the body. Over time, if left untreated, the hole could damage the valve and cause dangerous problems such as aortic regurgitation, where the blood flows backward through the aortic valve, Dr. Welke adds. Fortunately, Cienna and her family could wait until she was a little older to have the surgery, which would be less risky than performing the operation when she was still a newborn.
“Other than her heart murmur, she was perfectly healthy,” DeSpain says. “We knew she’d eventually need the surgery one day so she could have a long and healthy life.”
Advanced Surgery Repairs Tiny Hearts
That day came in September 2013, when doctors decided Cienna was ready for the operation. “Before the surgery I was really scared,” says Cienna’s father, Caleb Mendez. “But once we talked with Dr. Welke that morning, I felt really comfortable with him. He also took the time to talk with Cienna and make sure she was comfortable with him, too. All of the nurses ensured me that my daughter was getting the very best care—and that’s exactly how I felt.”
For the surgery, Dr. Welke had to make sure there wasn’t any blood moving through Cienna’s heart. To that end, he used a heart bypass machine that allows blood to bypass the heart and lungs and reenter the patient in the aorta. He made an incision in the pulmonary artery to access the VSD. Once there, he closed the hole by sewing a patch ofsynthetic material around its edges. Finally, he took Cienna off the heart bypass machine. To confirm that the defect was completely closed and Cienna’s heart was working well, Dr. Welke used an ultrasound device to create a clear image of her heart.
No Limits for This Little Girl
Cienna recovered in the hospital for three days before returning home. “Within a few days after surgery, she was running around,” DeSpain says. “You wouldn’t have been able to tell that she’d just had major heart surgery. She was back to her normal self.” Cienna continues to receive follow-up care at the Children’s Hospital of Illinois clinic in Rock Island. “There are a lot of kids out there with congenital heart defects, and the vast majority of these kids live very normal lives,” Dr. Welke says. “Cienna is going to be able to do whatever she wants in her life. Whether she wants to be a ballet dancer or a marathon runner, her heart isn’t going to limit her in any way.”