Hurricane Katrina evacuee receives life-saving surgery

When Toya Atkins evacuated her family days before Hurricane Katrina destroyed their home in New Orleans, she was unaware that a hidden cardiac condition was threatening something even more precious, her 17-year-old son Brandon.

Brandon arrived at Children's on Jan. 25 with flu-like symptoms including a fever, body chills and lethargy. A day later, he was admitted to the Cardiac ICU at Children's with a diagnosis of endocarditis, an inflammation of the inside lining of the heart chambers and heart valves.

Dr. Steven Leonard, a cardiothoracic surgeon on the medical staff at Children's, said endocarditis is a rare diagnosis for a healthy 17-year-old.

"Most people who develop this inflammation have underlying valvular heart disease. I suspect Brandon was born with a bicuspid aortic valve where rather than having the normal three leaflets, his probably only had two," Dr. Leonard said. "Whenever you have an abnormal valve with turbulent blood flow, it's a set-up to develop endocarditis."

A life-saving decision

Brandon's hospitalization was the culmination of an unbelievable period of time for the Atkins family who, just six months prior, had fled their home in New Orleans to escape the destructive path of Hurricane Katrina. Little did they know that the selection of Dallas as their new home would prove to be life saving.

"At one point in time, shortly after Brandon's diagnosis, I thought I was going to lose my child," said Toya Atkins, Brandon's mother. "I didn't know what to do, but I knew he was in good hands at Children's."

Dr. Leonard said that Brandon's seemingly healthy body had been degenerating for some time, which explains his abrupt decline in health.

"Your body can compensate for a long period of time with a lot of the problems our body faces, and then it's kind of like walking off the edge of a cliff. Once you fall over, your body goes downhill fast," Dr. Leonard said. "It was obvious that Brandon was at the end of a long course of infection and that he was unaware of the toll it had taken on his body."

Cardiac intervention

Brandon received an echocardiogram, an ultrasound of his heart, to determine the extent of damage. When Dr. Leonard reviewed the image with Dr. Claudio Ramaciotti, a cardiologist on the medical staff at Children's, it was evident the endocarditis was progressing rapidly, destroying the aortic valve and creating a hole between the two ventricles. It was clear Brandon required immediate cardiac intervention to save his life, Dr. Leonard said.

Dr. Leonard performed Brandon's first surgery on Jan. 27, implanting an artificial aortic valve and closing the ventricular septal defect. A pacemaker was implanted two weeks later to electrically stimulate the heart to contract and pump blood throughout Brandon's body.

For the next month, Brandon appeared to be recovering as expected with no cause for concern. Then, in early March, his new aortic valve began leaking, and a second surgery became necessary.

"Although disappointed, I was not all that surprised that the first repair degraded so quickly, because the tissue I sutured to was very weak to begin with," Dr. Leonard said. "It's just the nature of attempting to implant an artificial valve in the face of infected tissue."

For the second cardiac surgery, Dr. Thomas Yeh and Dr. Hisashi Nikaidoh, cardiothoracic surgeons on the medical staff at Children's, devised a procedure that replaced Brandon's mitral valve and his aortic valve to provide a more secure repair.

"They sewed the two new valves into an artificial patch of material and then implanted the whole device into the heart, which was pretty ingenious," Dr. Leonard said. "Each heart is just a little bit different. You always go in with a game plan, but you change it as necessary, and the surgeons did a great job."

Now, several months removed from his multiple valve surgery, Brandon is feeling better and looking forward to seeing friends and family in New Orleans.

"I look forward to seeing people back in Louisiana. I want to go out there and put some smiles on their faces," Brandon said.

The power of music

As a lyricist for a rap group, Brandon is most comfortable expressing his emotions through music. Fortunately he found a kindred spirit in Karen Norris, one of two music therapists in Child Life.

"Karen and I really connected. We both like music, and I enjoyed spending time with her," Brandon said. "Sometimes in the hospital you get bored, but it's nice to have someone who shares your same interests. It helped me pass the time after my surgeries."

Norris was impressed by Brandon's maturity and the way he used music to express his feelings. "Brandon really seemed to get the music and its importance," Norris said. "It provided him an opportunity to release the emotional stress surrounding his hospitalization and his family's displacement from Hurricane Katrina."

Music therapy at Children's is delivered by board-certified music therapists to meet patients' physical, psychological, emotional and spiritual needs through the use of musical interventions. Music therapy sessions are designed to help patients, like Brandon, and their families cope with hospitalization. The service is funded solely through donations and grants and is provided at no-cost to the patient.

Patients in the hospital often experience fear, anxiety, or a general lack of control. Music therapy addresses these and other needs by providing opportunities for patients to make independent choices and by encouraging self-expression.

Tags: heart