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Patient Care July 06, 2018

Young patient benefits from hospital's bloodless surgery program

By Erin Digitale

Ten-day-old Lola Garcia became the smallest infant in North America to receive bloodless open-heart surgery.

When Lola Garcia was born last October, she struggled to breathe. Doctors said she needed open-heart surgery to repair a serious congenital heart defect. Her parents were very worried.

Today, the Garcia family's life has changed. Thanks to surgery performed at Lucile Packard Children's Hospital Stanford when Lola was just 10 days old, she's a thriving 8-month-old who loves laughing at her big brother.

"She smiles at everybody," said her mom, Felisa Garcia. "I've never seen a happier baby."

Lola's journey to health was more complicated than for many babies with heart defects. Her diagnosis, transposition of the great arteries, requires use of a heart-lung machine for surgical repair. In most instances, infants placed on heart-lung machines need a blood transfusion. But the Garcias, who are Jehovah's Witnesses, wanted to avoid a transfusion because of their religious beliefs.

Their medical team in Southern California, where the family lives, contacted children's hospitals across the country, but most were not prepared to attempt Lola's procedure without a transfusion. Packard Children's was different: The surgical team at the Betty Irene Moore Children's Heart Center had been building a bloodless surgery program and agreed to accept the case. Lola was emergently airlifted to Palo Alto.

On October 31, in a seven-hour operation performed by surgeons Frank Hanley, MD, and Katsuhide Maeda, MD, Lola became the smallest infant anywhere in North America to receive bloodless open-heart surgery. The team closely monitored her throughout the surgery and recovery to ensure her red blood cell counts stayed in a safe range.

"There were multiple decisions we made before, during and after surgery to minimize the likelihood of bleeding," Hanley told me.

That type of careful decision making is extended to every baby Hanley's team treats. The decisions start with important choices about when each infant should receive surgery. Babies diagnosed in utero with severe heart defects may be taken to the operating room immediately after delivery. Infants like Lola, who could be temporarily stabilized with medication, are given a few days or weeks in the neonatal intensive care unit to recover from birth before surgery. Other children are best served by going home with their families to grow, then receiving a surgical repair of their heart at a few months of age.

"Our goal is to perform surgery for every congenital heart defect at the time that's safest and most appropriate for each patient," Hanley said. "In Lola's case, our whole team made sure she got the best care we could give at just the right time."

Back home with her family in Hemet, California, Lola is doing well. She's getting twice-yearly checkups to monitor her heart. "Other than that, she's pretty much a normal baby," Felisa said, adding that Lola is learning to crawl, eating her first solid foods, and giggling at her reflection in the mirror.

Best of all, her brother, 2-year-old CJ, has discovered that Lola makes an excellent audience for his superhero antics.

"He pretends to be Spiderman, jumps and does karate kicks in the air," Felisa said. "He's super sweet to her. And she cracks up. It's really cute to hear."

This piece originally appeared on the Healthier, Happy Lives Blog.

Photo courtesy of Lucile Packard Children's Hospital Stanford

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Senior science writer

Erin Digitale

Erin Digitale, PhD, is a senior science writer in the Office of Communications. She earned a bachelor’s of science in biochemistry from the University of British Columbia and a doctorate in nutrition from the University of California, Davis, where she helped develop a new animal model of Type 2 diabetes. She holds a certificate in science writing from UC Santa Cruz and writes for the Stanford Medicine about pediatrics, obstetrics and gynecology, nutrition, and children’s health policy. Erin’s writing has been recognized with several national-level awards from the Association of American Medical Colleges and the Council for the Advancement and Support of Education. When she isn’t settling down at her desk with a pile of scientific studies and a large cup of tea, you can find her swimming, experimenting in the kitchen or going on hikes with her kids.