In the middle of an April night, Traci Wardle and her family huddled in the waiting room at LDS Hospital and discussed what they'd do if Traci's daughter, Mikayla George, 10, died. That she would in the coming weeks become a medical pioneer of sorts didn't enter their minds.
April 26, Dr. James W. Long implanted what amounted to a total artificial heart in the girl. Thursday night, after only six weeks on the Thoratec bi-ventricular assist device (Bi-VAD) and after only two days on the waiting list for a human heart, she got one. The little girl, who lives in Herriman, is the youngest person in the region to have received an artificial heart (one of very few in the country) and is now the youngest heart transplant patient ever at LDS Hospital.
Two months ago, as she ran around the bases at softball and splashed in the community pool, no one suspected the fourth-grader would soon be a frail child who now struggles not only with recuperating from a massive surgery, but also with overcoming the effects of a stroke she suffered when she first became deathly ill.
She has ideopathic cardiomyopathy. Ideopathic translates roughly as "we don't know where it came from." Her family was in the process of moving when she first complained she was tired and her chest hurt in early April. Her mom thought she was trying to get out of helping. A couple of days later, a doctor said she had pneumonia. Within days it was clear she was seriously sick. Her color was bad.
At Primary Children's Medical Center, tests brought the diagnosis, but she was slipping away. Despite everything the hospital could do, she was dying.
Her doctors called in Long, head of the artificial heart team at LDS Hospital, to examine her. At that point, she had less than 10 percent heart function. They rushed her back to LDS so a ventricular-assist device could be implanted.
The normally four or five hour surgery stretched to 19 hours as complications cropped up. A heart that isn't squeezing lets blood pool and that creates blood clots. The heart team spent more time plucking clots out of her lung and legs than in implanting the device. Heart failure leads to other organ failure and it all had to be dealt with. It was in that long wait that the family started talking about what they'd do if she died.
A few days after the successful Bi-VAD implantation, they found she'd had a stroke. It was not clear when it happened, but as she began to rally from the surgery, it was obvious she couldn't move — still can't move — her left side. Her cognitive skills are not impaired. And she has some sensation, so it's quite likely with hard rehabilitative work she'll regain use of those muscles and limbs, Wardle said.
She's been in the hospital since she got the Bi-VAD, tethered to the mammoth device that drives her two pumps. The other Utah Bi-VAD recipient, Bambi Thomas, sometimes visited. The artificial heart is a bridge to human transplant; they've known all along they'd both need donor hearts. The Bi-VAD has kept them alive for the wait and let their bodies recover from the ravages of their diseased and dying hearts.
In what seems to Wardle like another miracle, Mikayla had only been on the waiting list for two days. Before that, doctors felt she was still too frail for such a surgery, said Karl Nelson, clinical director of the Utah Artificial Heart Program. She'd been gaining strength every day.
Because LDS Hospital doesn't usually treat children Mikayla's age, she's become a staff favorite. Nelson describes her "charisma" and "zest for life," noting many adults could not have survived what she's been through.
She still has a long journey ahead of her, including recovering from the stroke and healing from the transplant. She'll always need anti-rejection medicines, but the heart was a perfect match and, in the words of one physician, the heart's and Mikayla's natural antibodies "like each other."
E-mail: lois@desnews.com