VITAL ROLE OF THE NEONATAL INTENSIVE CARE UNIT As the only Level IV NICU in South Texas , The Driscoll Neonatal Intensive Care Unit ( NICU ) is central to The Heart Center ’ s care for babies born with heart conditions . The main medical problem for about onethird of the patients in the NICU is a complex heart defect . Many defects involve multiple organs , which increases the types of specialists involved in intensive care .
“ We provide medical management in the NICU until a newborn becomes stable enough to have surgery or gets to the point that surgery can be avoided ,” said NICU medical director Miguel DeLeon , MD . “ With today ’ s prenatal imaging techniques , many babies are diagnosed with heart defects before birth and receive medical management before they ever arrive at the NICU ,” Dr . DeLeon said . “ Our prenatal care sometimes makes it possible for a newborn to avoid being in the NICU at all .”
When the medical team knows in advance that a baby will need surgery immediately following birth , the NICU and cardiac specialists work together to ensure everything and everyone is in place to begin treatment when the newborn arrives .
“ We plan and prepare for neonatal care in collaboration with Driscoll ’ s fetal cardiologists and maternal fetal medicine doctors , and the expectant mother ’ s local physician ,” said Dr . DeLeon . Expectant moms who live in the Valley receive maternal fetal medicine care at Driscoll ’ s local specialty centers , and they are scheduled to deliver at their local hospital , or if necessary , a facility close to Driscoll .
Driscoll pediatric cardiologist Ngozi C . Agu , MD , lives and works full-time in the Rio Grande Valley .
COVER STORY · MAY 2018
Dr . DeLeon described a recent case that illustrates how prenatal diagnosis and planning enable a newborn to get immediate cardiac care at Driscoll . Fetal echocardiography found that baby Sam ( not his real name ) had transposition of the great arteries , in which the two large vessels that carry blood from the heart to the lungs and rest of the body were connected to the wrong right and left ventricles . This defect causes the blood to lack proper oxygen , a lifethreatening condition . It is one of the causes of “ blue baby syndrome .”
“ As a result of the prenatal diagnosis , Sam ’ s mother was scheduled to travel from the Valley to Corpus for delivery by C-section ,” said Dr . DeLeon . “ Once at Driscoll , Sam underwent catheterization to improve his oxygen level . Cardiothoracic surgeons then performed an arterial switch to flip the arteries to the correct ventricles . Sam made a good recovery , and he went home like any other normal newborn .”
PRE- AND POST-SURGICAL CARE IN THE PEDIATRIC INTENSIVE CARE UNIT The Pediatric Intensive Care Unit ( PICU ) is another essential part of the Heart Center . After heart surgery , patients receive post-operative care in the PICU until they are feeding , growing , and thriving well enough to go home . The PICU is located next to the cardiac surgery suite to allow for immediate post-op care , and for a rapid return to surgery if needed .
Sometimes a baby born with a heart defect has no symptoms until several months later . When brought to Driscoll in serious condition , the child can be stabilized in the PICU before receiving treatment . Intensive care staff work in concert with cardiac specialists to diagnose the problem and plan treatment .
Ramon Rivera , MD , is a critical care specialist , or intensivist , in the PICU . In describing The Heart Center at Driscoll to South Texas parents whose children need cardiac care , Dr . Rivera said , “ It is the place you want your child to be . Our heart team can address all of your child ’ s needs , from making the proper diagnosis and providing the most complex treatment to monitoring your child ’ s condition all the way into adulthood .
“ Children living with congenital heart disease are more vulnerable to illnesses and infections even when not related to a cardiac problem ,” said Dr . Rivera . “ Anytime one of these children has a significant illness , the PICU is involved with the child ’ s care .”
MAKING TREATMENT AND RECOVERY EASIER Dr . Khan ’ s work in Driscoll ’ s cath lab includes diagnosis and treatment of heart conditions . Catheterization involves using a long , thin flexible tube ( catheter ) that is inserted into a child ’ s vein or artery and threaded to the heart . Dr . Khan guides the catheter to the right place using special X-ray and ultrasound equipment .
Several sophisticated procedures , such as closing holes in the heart and opening up narrowed valves , are done in the cath lab . “ Very often this treatment allows a child to avoid surgery and recover faster ,” said Dr . Khan . “ The child leaves the cath lab with a bandage and can usually go home the next day .”
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I BELIEVE THE CARE PROVIDED BY THE HEART CENTER AT DRISCOLL CHILDREN ’ S HOSPITAL MATCHES THAT OF ANY LEADING PEDIATRIC HOSPITAL IN THE U . S .”
MUHAMMAD KHAN , MD , FAAP , FACC , FSCA
Dr . Khan recounted the case of a 16-month-old child with a ventricular septal defect — a hole between the right and left ventricles . The condition was diagnosed and treated through catheterization . “ The hole was large , which made closing it challenging ,” said Dr . Khan . “ Even so , we were able to perform the necessary treatment in the cath lab and avoid openheart surgery .”
For many babies with highly complicated heart problems , Dr . Khan and Driscoll ’ s cardiothoracic surgeons collaborate on “ hybrid ” procedures that combine catheterization and surgery at the same time . “ Doing these together can reduce the length and number of surgeries and lower the risk of complications ,” Dr . Khan said . “ We have a special surgical suite that has space for portable cath equipment for hybrid treatments . Having this kind of facility is one of the big advantages Driscoll offers .”
WORKING IN TANDEM WITH COMPASSION Anesthesiologist Dr . Alanmanou is involved in multiple cardiac procedures , including magnetic resonance imaging ( MRI ) and echocardiography as well as surgery and catheterization . He is also responsible for pre-operative patient assessment and post-operative monitoring and pain management . He works in tandem with many other specialists .
“ Cardiovascular anesthesia depends on excellent teamwork ,” Dr . Alanmanou emphasized . That is also true of every specialty service at Driscoll in Corpus and in the hospital ’ s Valley locations .
The Heart Center has a large team of highly trained medical professionals that also includes highly skilled nurses , echocardiographers , pharmacists , nutritionists , and an electrophysiologist . The team expands according to patient needs and may include a respiratory therapist , kidney specialist , pulmonologist , and numerous other pediatric specialists .
“ We all do what it takes to provide the best , most compassionate care for patients and support for their families ,” said Dr . Alanmanou . That care includes a team of specialists devoted to the specific needs of each child and family .
This comprehensive and responsive team , along with the most advanced technology and equipment , are what make The Heart Center at Driscoll Children ’ s Hospital the foremost children ’ s health facility in South Texas .
To learn more about The Heart Center at Driscoll Children ’ s Hospital , call 956-688-1300 or visit Driscoll Children ’ s Medical Plaza - McAllen at 1120 E . Ridge Road , Suite 210 .
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