Sunday, September 7, 2008

Best Children's Hospitals

Makenna and Her Transformed Heart: No Slowing Her Down

After three surgeries in four years, Makenna and her redesigned pump are ready for anything

Posted May 29, 2008

Makenna Franks turns 5 this month. She'll probably start dance class soon. She noshes on Fritos twists, chases after her older brother and her boy cousins, and tries to climb trees the way they can in her suburban Houston neighborhood. Just a regular kid. But less than a year ago, she was on the operating table at Texas Children's Hospital for the third open-heart surgery of her four-year life.

Makenna photo gallery
Makenna Franks, nine months after her third surgery.
Makenna Franks, nine months after her third surgery.
(Kevin Horan/Aurora for USN&WR)
Makenna Franks, nine months after her third surgery.
(Kevin Horan/Aurora for USN&WR)
Makenna Franks, nine months after her third surgery.
(Kevin Horan/Aurora for USN&WR)

Makenna was born with hypoplastic left heart syndrome, which affects about 1 in every 3,000 to 6,000 babies. In "hypoplasts," as doctors call these children, the left ventricle—the heart's main pumping chamber—and the aorta, which carries oxygenated blood to the body, stop developing before birth. Two of Makenna's heart valves also were defective.

Even as recently as the mid-'90s, most HLHS babies died. Gradually, however, a small group of surgeons has worked out a complex three-stage repair in which major vessels are rebuilt and rerouted to shift pumping chores to the right side of the heart. At Texas Children's, the death rate is now below 2 percent.

Makenna had the first stage as a 3-day-old infant and the second one at six months. Last August, Charles Fraser, chief of congenital heart surgery, performed the final step, which U.S. News chronicled in "Makenna's Heart" [September 3].

Recuperation wasn't fun. Her lymphatic system leaked fatty fluid into her lungs and around her heart, so Makenna was kept on a no-fat diet for six weeks after surgery. No Fritos. "Her big day was when she could finally eat those things," says pediatric cardiologist Michelle Grenier of Texas Children's, who has seen Makenna more than 10 times, most recently last month to run a battery of tests. "We want to watch these kids very, very closely," she says—measuring their blood oxygen, for example, to make sure their reworked hearts are pumping enough oxygenated blood.

The replumbed heart is working well, says Grenier. She pronounces her patient "just amazing—she knows she has a zipper on her chest, but she won't let it slow her down." Nor does Grenier think she should. "One of our concerns with our cardiovascular patients is that parents have a tendency to baby them, worry about them playing too hard, maybe feeding them a little too indulgently. Can she dance? Ride a bike? You bet."

Bobby and Brandi Franks aren't take-it-easy-sweetie parents. "We don't limit her," says Bobby. Nor do they assume that their daughter's life will now be perfectly normal. "Along the way I'm sure there will be bumps, and we'll do what needs to be done," says her father.

A recent study in the journal Circulation suggests that Makenna has a good shot at a smooth road. Researchers tracked every Children's Hospital Boston patient born prior to 1985 who had Makenna's type of surgery. Most, even those who had the procedure many years ago, were alive 20 and 25 years later.

"If Makenna came to me as a teenager and asked if she could run a marathon," says Grenier, "I would tell her she probably could—if she'd been doing as remarkably well as she has so far."

Reader Comments

HRHS

My little Miranda had the HRHS. She had two surgeries aldready. She is going to have heart catherization in september because her oxygen saturation is low. I am very wory about her every time she is trying to catch her breath. Thank you to Dr. Charles Fraiser and the staffs of Texas children Hospital.

HLHS is still very serious, even with the high success rate for surgeries

My first son, Kenneth, was born with HLHS. Unfortunately, his subset (mitral stenosis, aortic atresia) created some additional deformities in his heart that weren't discovered until his first open-heart. He passed away 1 month and 3 days after his birth.

It is my fervent prayer that the surgeons and researchers will continue to pioneer new and better methods of helping our HLHS kiddos, so that no other parent has to bury their child because of this awful defect.

hELLO

mY SON BRANDON T.WAGA, WAS BORN WITH HLHS, IN 2000. THANKS TO KOSAIR'S CHILDREN HOSPTIAL, LOUISVILLE, KENTUCKY, AND BY THE HANDS OF SURGEON DR. AUSTIN, MY SON IS DOING WELL. IS NOT BEING EASY FOR THE WHOLE FAMILY BUT HE IS STRONG FIGHTER, AND THAT MAKE US MORE STRONGER. HE IS NOT ONLY HLHS BUT HE IS ALSO HDHD, AND HE JUST RECENTLY DEVELOPED GASTRITIS EOSHENOPHILIA, AND PLE. HOPEFULLY DOCTORS CAN RESOLVED THESE OTHER ISSUES. WE JUST RECENTLY MOVE TO COLORADO, AND THE ALTITUD IS AFFECTING HIM, A LITTLE BIT.

CARMEN WAGA

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