Teamwork is critical—Chantal and Shane Dueck credit the specialized skills of an RCH care team for saving baby Brielle.
“Royal Columbian is the only hospital in B.C. where this could have happened all under one roof,” says cardiac surgeon Dr. Tim Latham. “Other hospitals specialize in high-risk maternity and newborn intensive care or cardiac surgery, but not both. This family was so fortunate to have access to all these highly specialized resources in one centre at RCH.”
The multidisciplinary team of nurses, doctors and other staff members assembled to handle the case accepted a challenge that was not merely medical, but also emotional. Repairing the heart of a woman who is 18 weeks pregnant involved not one life but two. As Clinical Nurse Specialist Jocelyn Reimer-Kent points out, “Fetal death is almost a certainty when an infected heart valve is added to the equation.”
The surgical team’s first goal was to save Chantal but team members modified some procedures to give the fetus a fighting chance. A specially trained cardiac anaesthetist, Dr. Michael Law, administered the anesthesia. To operate on the heart, surgeons have to administer a high potassium solution to stop it from beating. Once the procedure was complete the team tried to retrieve as much of the solution as possible to keep Chantal’s blood chemistry normal.
Chief perfusionist Don Trostheim increased the flow on the heart pump machine to keep her blood pressure higher than normal to ensure a good flow of blood across the placenta. Clinical pharmacist Dr. Wendy Gordon ensured that the drugs they were using posed the least risk to the fetus. Dr. Duncan Farquharson, a neonatologist, researched ways to protect the baby’s health during the procedure and after. Cardiologist Dr. Marg Blackwell also found ways to adapt normal medical-surgical practices to suit the unusual circumstances.
The happy ending, with mother and baby in excellent health, makes them “a walking statistic,” says Chantal, and definitely one for the medical journals.