Kids Like Dania.

Dania is an amazing little girl who suffers from a severe heart defect in her aortic valve known as aortic stenosis. The aorta is the main artery carrying blood out of the heart. Because Dania’s aortic valve was abnormally narrow, blood could not flow easily out of her heart to her body and brain. Dania had her heart repaired last week by our team in Benghazi, Libya.  On the night of October 18th, Dania had to have an emergency reoperation. Below is a recount of the life-altering collaboration of our Babyheart team and the local team from Babyheart PICU nurse, Elizabeth:

“On Friday, we had to emergently open the chest of our 3 year old aortic stenosis repair from that day. One minute Dania was smiling and playing with me and literally the next second she’s was limp and grey.

The local surgeon, Dr. Wejdan, was in the hospital at the time. From Tripoli, Dr. Wejdan has come to Benghazi to receive training from our Babyheart team. Dr. Wejdan quickly performed a resuscitation. Meds, volume…she’s back, crying but good vital signs.  We speculate that maybe she just kinked her IV. Then Dania goes limp and grey again. Her blood pressure is very low. That’s when we notice her chest tube drain is full of fresh blood, but it isn’t bright red blood like she blew the sutures on her new aortic patch. It’s dark and coming fast.

Dr. Wejdan produces a kit to crack the chest and before I had even finished drawing up another set of code medications, she’s opened Dania chest and is asking for suction. It got very chaotic for a few moments. The first suction head suddenly quits working, the second doesn’t have a collection container and we suck blood straight into the central wall suction system, and our unit’s portable suction also suddenly quits working. Without suction, the local surgeon can’t see anything in the flooded chest cavity. One of the local nurses runs to the adult ICU next door and grabs their portable suction machine. Babyheart Founder and surgeon, Dr. William Novick, has rushed to return to the hospital and has scrubbed in to assist while I’m digging underneath the surgical drapes to set up a med and fluid administration line. The local nurses are organizing supplies for the surgeon, drawing up extra medications while the doctor is organizing a blood transfusion. They did great!

They get the suction, I get my lines straight and it’s a tense one and a half hours of trying to repair the hole in Dania’s superior vena cava where her suture came out. The suture line from where they had connected the bypass machine in surgery had blown allowing all her venous return to just dump into her chest cavity instead of going to the heart.

Now, she really needs a blood transfusion. We’ve already over hemo-diluted what little blood she had left with normal saline. About an hour in, we lose the blood pressure. There’s no heart rate. The surgeon is doing cardiac massage and my epinephrine and atropine doses do nothing. At the start of this, we had sent the family off to the hospital blood bank to donate. That was over an hour ago. A very long five minutes pass. I can see the

patients little foot poking out from under the surgical drape and it is so very, very pale.

At what seems like the very last moment, the blood arrives.

I connect it and we pour it into her. Almost instantly her heart rate comes back. Slow at first and then strong. Blood pressure is back too.  It takes just a few more minutes for the surgeon to finish repairing the offending hole. After another half hour of trying to get the needed sutures and chest closure material, she’s finally done. She is alive.”

Dania had her breathing tube removed 38 hours later and quickly left the ICU. Dania has charmed our team and the local staff. She would come down to the ICU multiples times a day, just to visit everyone. Thanks to the quick response from our Babyheart team and the local team, she recovered wonderfully and was discharged from the hospital last Saturday, October 26th. Babyheart PICU nurse, Randa, summed up the impact of our work in a few sentences, “Dania is the reason I work with kids….they are so resilient!  No way would an adult ever recover from what she has been through in such a short time.  Just 5 days ago she was having her chest opened up in the ICU and almost died! It’s truly amazing and inspiring.  When someone tells me, “oh it must be so sad to work with kids doing what you do,” I tell them about kids like Dania.”