Undergo a hybrid procedure

A hybrid procedure combines minimally invasive catheter techniques performed by Zampi with surgical techniques performed by Romano.

“When we talk about a hybrid procedure, it means any procedure where you combine surgical and catheter-based techniques at the same time,” Zampi said. “Dr. Romano and I work closely together – shared decision-making and shared technical expertise – and by combining these different skill sets, you get the best of both: a procedure that is as minimally invasive as possible, but as efficient as possible. . »

Hybrid procedures can be used in a variety of high-risk patients, ranging from those born with a single pumping chamber or ventricle to those with complicated forms of congenital heart disease where the heart may have numerous abnormalities and require complex repair on the road. The team within the Congenital Heart Center at Mott is one of the few in the country with extensive experience using the hybrid procedure in both of these situations.

Mott’s team was able to apply their experience to Sullivan’s unique situation. The goal of Sullivan’s hybrid procedure was to give him stable circulation while allowing his left ventricle to recover, if possible, from whatever had impaired function or, at the very least, to buy him some time. while waiting for a heart transplant.

“This approach is the one we use for the highest-risk cases,” Romano said. “It’s a way to stabilize a sick newborn… get a stable physiology, get them off a ventilator and allow them to go home and grow.

“When we look at a patient, we look at what’s going to give them the best quantity and quality of life,” she added.

During Sullivan’s hybrid procedure, bands were placed over Sullivan’s pulmonary arteries to restrict some of the blood flow while a stent was placed between the aortic and pulmonary artery to ensure unobstructed blood flow to the body. He was added to the heart transplant list and began his recovery in the Pediatric Cardiac ICU.

A healing heart

After seven weeks in the hospital, living in Sullivan’s room or at the nearby Ronald McDonald House, Elizabeth and Brandon received some amazing news.

“One day, one of the heart transplant doctors came in and told us that he saw a slow progression of his left ventricle starting to repair itself and functioning more than it had, Elizabeth said. . “So they said, ‘If his heart heals, we should give him time to see how he heals. “”

His heart was healing so well, in fact, Sullivan was moved to inactive status on the heart transplant list, meaning his healthcare team believed he wouldn’t need a transplant after all.

“After learning how unlikely his heart was to recover, we were shocked to learn that he was beginning to heal on his own,” Elizabeth said. “His incredible strength as well as the incredible medical care he received in those first weeks of life is truly, in our eyes, a miracle.”

With Sullivan getting stronger, the family was finally able to return home to Canton, Michigan in April 2019 when he was 8 weeks old.

“There were a lot of ups and downs when we were in the hospital during those weeks. He had two cardiac arrests; it was really tactile. For us, coming home was really a big deal,” said Elizabeth said.

We always knew that a second surgery would be necessary, whether it was a heart transplant or another option. But thanks to the initial hybrid procedure, he was able to return home and live a relatively normal childhood until the second surgery was needed.

Back to Mott

In December 2019, when Sullivan was just 10 months old, he returned to Mott for a second operation. His healthcare team had decided it was time to see if his heart could function on its own. This surgery essentially undid what had been done during the hybrid procedure in an attempt to get Sullivan’s heart to function normally on its own.

“Sullivan had two ventricles and a structurally normal heart, he just had this heart attack,” Romano said when explaining why he was a good candidate for this procedure.

The hybrid surgery had allowed her heart to rest and heal for almost 10 months. It meant he was bigger and stronger, which is a very good thing as he had several postoperative complications.

A few days after the operation, Sullivan had to be put ECMO, a form of life support, for three days as his heart and lungs recovered. In total, he stayed in the hospital for three weeks.

“He gradually got better, day by day,” Elizabeth said.

Sullivan today

Since returning home, Sullivan has thrived.

“He’s healing and growing, and his heart just works on its own,” Elizabeth said. “He’s on two blood pressure medications, and his left ventricle is still technically slightly depressed, but his body doesn’t know anything different, so he’s just grown and adapted to that.”

At almost three years old, Sullivan is “very fiery,” Elizabeth said. “He’s got a lot of personality. He’s very funny. He’s very affectionate, he has a permanent smile on his face.

Zampi sees him every 6 to 12 months in his clinic and does not expect any future surgeries for Sullivan.