A New Heart

Jada Christian wasn’t supposed to live. She was diagnosed in utero at 22 weeks with heart block — a rhythm disorder — with congenital heart disease and heterotaxy syndrome. Scientific literature says kids like Jada don’t make it.

At Le Bonheur Children’s Fetal Center, Jasmine learned her daughter’s only hope was a heart transplant.

“I was afraid, devastated and heartbroken. I was told early on that the odds were definitely against us. I wondered how would this play out. Is it worth the risk, will she be in pain,” said Jasmine Christian, Jada’s mother.

This spring, thanks to Le Bonheur’s comprehensive pediatric heart transplant program, Jada beat the odds.

The diagnosis

When a routine ultrasound mid-way through Jasmine’s pregnancy revealed several abnormalities, she was referred to Le Bonheur Children’s Fetal Center. The multidisciplinary Fetal Center is one of fewer than 30 centers in the country focused entirely on babies diagnosed in utero with a congenital anomaly. There, she learned of Jada’s rare heart defect: heart block with congenital heart disease and heterotaxy syndrome. Not only was her baby’s heart in the reversed anatomical position, but its structure and electrical system were also abnormal. Her heart beat too slowly. Only 17 percent of babies with Jada’s diagnosis survive the neonatal period.

For eight weeks, a multidisciplinary team at Le Bonheur’s Fetal Center and Heart Institute developed a plan for Jada. Jada’s team included maternal fetal medicine specialists, pediatric cardiologists, pediatric radiologists and pediatric cardiovascular surgeons.

The team met several times to discuss Jada’s case and carefully map out her complicated transplant surgery. The procedure required a complex plan for removing Jada’s diseased heart and reconnecting the abnormally wired veins and arteries to the donor heart’s normal anatomy.

“Our preoperative  preparation was extensive. We thoroughly investigated what were the technical difficulties and how to overcome this. Once these details were worked out we were fairly confident that we would be successful in performing this transplant,” said Umar Boston, MD, surgical director of Le Bonheur’s Heart Transplant and Mechanical Circulatory Support program.

Jada was born full term on Feb. 9, 2017, and was immediately transferred to Le Bonheur’s Cardiovascular Intensive Care Unit to be monitored and treated until she could be listed for a new heart. Boston placed a Blalock-Taussig-Thomas (BTT) shunt when Jada was 25 days old to increase pulmonary blood flow, while she waited.

“The goal was to manage her heart and other organs in order to maintain wellness pre-transplant,” said Jeffrey Towbin, MD, co-director of Le Bonheur’s Heart Institute and Jada’s cardiologist.

In preparation for a new heart, Le Bonheur Pediatric Radiologist Jignesh Shah, MD, used Osirix technology to develop a three-dimensional volumetric analysis of Jada’s chest cavity to help facilitate finding a compatible-sized donor.

Jada was listed for a new heart on March 28, 2017, and on April 27, 2017, Jasmine learned her baby was going to be transplanted.

“We found out she got a heart at about 9 that night. Finding out Jada received a heart was a unexplainable feeling. We were all so excited and thankful! We had been praying and waiting for what felt like an eternity,” said Jasmine.

The next day, in a 10-hour operation, Boston and his surgical team performed Jada’s heart transplant. The transplant was a success. Jada remained in the CVICU for 12 days for recovery. She will continue immunosuppressive medications for the rest of life and follows up in clinic regularly with Towbin and her other transplant cardiologists and coordinators. Today, she is a happy 1-year-old baby, says Jasmine.

“Jada loves playing with her big brothers, Cameron and Chandler. She enjoys taking baths and watching Strawberry Shortcake,” said Jasmine.