Cardiology Experts At Rush University Medical Center Successfully Use Unique Interventional Procedure To Save A Girl With A Very Rare Heart Defect

Main Category: Cardiovascular / Cardiology
Also Included In: Heart Disease
Article Date: 14 Jun 2009 - 0:00 PDT

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Seventeen-year-old Sara Abousuiony, who has been homebound since she was an infant, never imagined that she would be able to leave her home in Cairo, Egypt, and travel to the United States for a life-saving heart procedure.

According to her mother Safa, "Sara would be connected to an oxygen mask all day to help her breathe when most young girls her age should be in school, hanging out with friends and enjoying her youth."

"It was heartbreaking to see her deteriorating in front of our eyes. I did not want to just watch her die just like her brothers and sisters," said Safa. "Now, we have hope that we can some day see Sara continue to grow and blossom."

Sara is the sole survivor of the Abousuiony children. Three of her siblings all died due to congenital heart defects.

Now, doctors at the Center for Congenital and Structural Heart Disease at Rush University Medical Center are saying she is doing well and able to go back home only a few days after successfully receiving a complex, minimally invasive procedure on Friday, June 5.

Suffering from a condition known as Double Outlet Right Ventricle (DORV), Sara has had several open heart operations over the years to try and correct the defect.

DORV is a rare congenital heart defect found only in about 1.5 percent of all patients with congenital heart disease where both of the great arteries of the heart (the aorta and the pulmonary artery) are connected to the right ventricle instead of forming separate ventricles.

Normally, only the pulmonary artery that carries blood to the lungs for oxygen arises from the right ventricle. The aorta, which carries oxygenated blood from the heart to the body, normally arises from the left ventricle. The body is not able to get enough oxygen and the heart works harder to pump oxygen-rich blood through the body.

In most cases, the pulmonary artery and aorta can be separated and connected into the two separate lower chambers with open heart surgery. However, in Sara's case, a biventricular repair was impossible. So, in an open heart surgery at another hospital, a conduit junction was formed in her heart to connect the inferior vena cava to the junction of the left pulmonary artery, the right pulmonary artery and the superior vena cava.

"Even with this surgery, there was severe narrowing of this conduit junction due to scar tissue that made it difficult for the blood to flow properly," said Dr. ZiyadM. Hijazi, director of the new Rush Center for Congenital and Structural Heart Disease. "Sara needed to undergo a procedure to correct the narrowing."

Sara's doctor in Egypt explained that there was no one locally who had the expertise to do the delicate procedure to correct the narrowing. That's when Egyptian friends and neighbors helped to raise funds to send her to the United States to see Dr. Hijazi and the expert interventional cardiology team at Rush.

"This is a very unique case because we needed to stent the arteries in three places to strengthen the vessel and open up the blockages in her heart in order to keep the blood flowing," said Hijazi. "We had to carefully thread one tiny stent through the struts of the other tiny stent."

All of this was done without open heart surgery. Using a small puncture in the groin area, Dr. Hijazi was able to snake a catheter, which is a small tube, through a leg vein up into the heart. A small wire with a tiny, mesh stent was fed through the cathether in the vein leading up to the heart and carefully placed. Then, Hijazi had to thread other tiny stents through each other and deploy them into a T-shape figure.

"What makes this case so distinctive is that a complex stenting procedure like this has never been successfully done using this type of equipment," said Hijazi, who along with his colleague Dr. Zahid Amin, pediatric cardiologist at Rush, completed the procedure in less than three hours.

After only a few hours upon completion of the procedure, Sara was up and talking. She was smiling and able to leave the hospital the following day.

"Sara's heart is working beautifully. It was an exceptional repair," said Dr. Sonia El-Saeidi, the Sara's doctor from Egypt who flew with her patient to observe the procedure. "We can see the narrowing was relieved and everything is fully functioning."

"I could only dream about being able to go to school and see family and friends outside of my own home," said Sara. "Now, it does not have to be a dream."

Sara, along with her mother Safa and kind neighbor Nagi who helped raise funds to bring her to Chicago are scheduled to go back home to Cairo on Thursday, June 11.

Source
Rush University Medical Center