November 04, 2010
Bright and blue-eyed, 9-month-old Logan Wallace is all smiles these days — a stark contrast to his condition at birth.
Logan was diagnosed with Transposition of the Great Arteries — a congenital heart defect — an hour after he was born. The condition causes the aorta and pulmonary arteries to be switched, leading to a lack of oxygen at birth. Richard and Beth Wallace, Logan's parents, received the news that Logan would need specialized care — and fast.
"We had no doubt in our minds that Logan needed to be at Children's," said Beth, a member of the Women's Auxiliary to Children's. "The staff and services are unmatched."
Equipped for success
The Heart Center at Children's, with its Cardiovascular Intensive Care Unit and team of critical care experts, has the proficiency needed to care for the smallest babies. The risk of death during an arterial switch — the procedure Logan would need — averages two to three percent nationally, but at Children's it has remained at zero percent over the past three years.
"The type of procedure we performed on Logan requires a very complete Heart Center team with a lot of experience working together to generate the maximum safety level," said Dr. Joseph Forbess, chief of Cardiothoracic Surgery at Children's. "We have performed this operation successfully on patients as small as two pounds."
Dr. Forbess holds the Pogue Distinguished Chair in Pediatric Cardiac Surgery Research and is an associate professor of Cardiothoracic Surgery at UT Southwestern Medical Center.
The life-saving process begins
At birth, Logan underwent a balloon atrial septostomy, a catheter-based procedure that widens an existing hole in the wall between the two upper chambers of the heart. The procedure improved the circulation of oxygen-rich blood and stabilized Logan until he was ready for open-heart surgery.
When Logan was two days old and 6.5 pounds, Dr. Forbess performed an arterial switch — repairing the holes in Logan's heart as well as switching the coronary arteries. For just over two hours, Logan was placed on the cardiopulmonary bypass machine, which pumps and oxygenates the blood. The heart was stopped for 95 minutes while Dr. Forbess repaired a hole in Logan's heart and exchanged the aorta and pulmonary arteries. During the procedure, the team focused on avoiding injury to Logan's electrical conduction system — a significant risk which would result in the need for a pacemaker.
"The most critical part of the operation was moving the small coronary arteries," Dr. Forbess said.
Despite the delicacy of the procedure, the Wallaces' confidence in the team treating Logan remained strong.
"Dr. Forbess is the premier doctor to perform this surgery," Richard said. "He trained under the doctor who performed the first arterial switch procedure, which has been in existence for nearly 30 years."
After four hours, Dr. Forbess met the family in the waiting room with positive news — Logan's repaired heart was beating perfectly.
"Logan more than likely will not require further surgery and he is expected to lead a normal and active life," Dr. Forbess said.
Through their involvement at Children's and Logan's experience, the Wallace family decided to create Logan's Gift — a foundation to support Cardiothoracic Surgery at Children's. Beth and Richard are members of the Children's Circle of Care and the Children's Trust — organizations that provide support to the hospital and host events to learn more about pediatric healthcare.
"When we moved to a regular patient room, it touched me to see a lot of kids whose families couldn't be at the hospital with them," Beth said. "We want to be available to help in any way they need us — both financially and through personal interaction. We put our names out there so we can talk with families who have questions about a recent diagnosis, or need someone who can relate."
Their other children — 3-year-old Lilly and 5-year-old Lleyton — are a vital part of the foundation. For Lilly's birthday party, they initiated a book drive and donated 50 books to the hospital. During Christmas, the family assembled activity bags for the patients. The next project in the works is a crayon drive through the children's school.
"We were thrown into the situation," Richard said. "Suddenly we had to drop everything and live at the hospital. Our hope is that through Logan's gift, we can provide supplies like coloring books and toiletries — essentials that are needed on a daily basis. We want to make the families' transition easier."
"We were told that more than 200 people would touch Logan's case before he left the hospital, and each person we met was amazing," Beth said. "We love everything about Children's and we will be completely devoted to the hospital for the rest of our lives."