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In the O.R. for Life-Changing Surgery Transplanting a Baby’s Heart

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Doctor: Sam Weinstein
Specialty: Pediatric Heart and Lung Surgery
Location: Montefiore Medical Center


Dr. Weinstein: The patient was 6 months old and had dilated cardiomyopathy, a condition in which the heart muscle becomes too sick to beat strongly enough to sustain life. He had months to live.

A good transplant has to go like clockwork. The patient arrived in the operating room, and I knew it would take me twenty minutes to open him up and prepare for the new heart. When I got the phone call that the heart had landed at Teterboro, I cut skin.

I started the operation by opening the chest and then connecting the patient to the heart-and-lung machine that keeps blood and oxygen circulating throughout the surgery. The heart was big, dilated—we use the phrase “bagged out.” The muscle was clearly diseased.

After removing the damaged heart, I prepared the remaining tissue for the new one and made sure there were no irregularities. That’s when the harvest team arrived with their igloo cooler. Anatomically, this heart was perfect.

First, I connected the new heart to the left atrium, then the right atrium, and then I sewed the pulmonary artery and aorta and let the heart fill up with blood. It took about five minutes for the first heartbeat. It’s an unspoken rule that we try to be quiet while we’re waiting for the heart to beat. Not every heart starts as vigorously as others, so out of custom or maybe even superstition, we don’t talk. We wait and watch. Once the heart was beating regularly, I said to the harvest surgeon, “Bill, you brought me back a winner.”

With child donors, it’s a tragedy. The heart had started the day in another baby. But now this little guy can have a life. He’s home. He’s gaining weight, sleeps well, plays. And his first biopsy showed that his body was not rejecting the heart.

As told to Katie Charles


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