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Long Day

By mid-morning Tuesday, all of Monday’s surgical patients had been moved to the step-down pediatric unit to continue their recovery. Going into Tuesday, the team knew it was going to be a long day. Three difficult surgeries were on the schedule.

Tiny, tiny one-month-old Karla has a heart defect known as a “co-arc” or coarctation of the aorta. Karla’s case was more complex because she also had a hypoplastic arch. Coarctation of the aorta is a narrowing of the major artery (the aorta) that carries blood to the body. This narrowing affects blood flow where the arteries branch out to carry blood along separate vessels to the upper and lower parts of the body. Coarctation can cause high blood pressure or heart damage. Surgery can very effectively repair a narrowing of the aorta, usually by removing the narrow section and reconnecting the two good ends of the aorta. (

Dr. Victor Paz was the lead surgeon with Dr. Steve Leonard serving as his mentor. Karla was brought to the ICU from the OR mid-afternoon. The team continued to work to stabilize Karla throughout the remainder of the afternoon and into the evening.

The second surgery of the day was two-year-old Jade. Jade is known as a “tet baby.” Tetralogy of Fallot is the most common heart condition. It is caused when blood lacking oxygen passes through the heart while oxygen rich blood is mixed with it. This causes a circulatory condition because the body isn’t receiving the oxygen it needs to survive and for all of the organs to function at an optimum level. Symptoms include a heart murmur, failure to gain weight and “tet spells” which occur when the brain is not getting enough oxygen. The “tet child” learns to squat to cut off blood flow to her legs so more blood is available for the brain. The surgery involves reconstructing the heart so that it works properly. (

Again, Dr. Paz was the lead surgeon; Dr. Nikaidoh served as his mentor for Jade’s surgery. Shortly after Jade was brought to the ICU, because of the late hour, the decision to postpone the third surgery until Wednesday was made.

One van of team members returned to the hotel around 8:30. During dinner, members of the OR were called back to the hospital as doctors determined that Karla needed to go back into surgery to repair a blood vessel that was leaking.

Many prayers were offered for Karla and the team as those folks left the dinner table to return to Ruth Paz. When Lori returned to our room just after midnight, it was such a relief to learn that Karla’s surgery had been successful and that Jade has been extubated and was doing well!

Quick morning update: both patients are doing well and two moms who were very teary-eyed and worried yesterday, were smiling at us and their little miracles this morning.

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