Miracle baby receives chance at normal life
Published: November 26, 2005
Sometime in the first seven weeks in the womb, Zachary Davis’s heart got the wrong instructions.
The intricate folding, splitting and sprouting that produces the heart’s four chambers and a tree of major blood vessels did not follow the normal genetic plan. The heart he was born with Oct. 20 was not the engineering marvel that can take people through nine decades. [It's My Heart]
Still, Zachary’s heart was a marvel in its own right. It shared many features of known congenital malformations. But it also had something not previously recorded in the annals of medicine. His coronary arteries, which normally deliver oxygen and nutrients directly to the heart muscle, were instead supplied by a bizarre circuit routed through his brain.
“It usually takes lot for us to say, ‘That’s amazing,’ ” Richard A. Jonas, a heart surgeon at Children’s National Medical Center, said. “We see a lot of unusual things. But this was out there.”
This exotic misassembly was good enough to get the baby through gestation. It would not be good enough to get him through life. A week after Zachary was born, Jonas took his heart apart, added missing pieces and reconstructed it to something close to its original specifications. It took about four hours and included a 25-minute period when the infant was packed in ice, with no blood circulating. [The Parent's Guide to Children's Congenital Heart Defects: What They Are, How to Treat Them, How to Cope With Them]
Zachary will need at least two more operations on his heart as he gets bigger. But doctors expect him to have a normal life.
“There are only a handful of people in the world who can take a problem like this, think it through, do a complete repair, and have the child turn out so well,” Mary Donofrio, Children’s director of fetal cardiology, said of Jonas. “He actually did three operations, and (Zachary) had no leftover heart defects.”
Jonas, 54, a native of Australia, went to Children’s last year after 20 years in Boston, where he was a professor at the Harvard Medical School. He is an advocate of “early primary repair” — fixing heart malformations right after birth in a single operation. The team being assembled around him is turning Washington into a referral center for ultra-complicated pediatric heart surgery.
Early primary repair is difficult, even daring. How Zachary would tolerate a one-stop solution to his many heart defects, including the unique one, was hard to predict.
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