Remarkable story of teamwork for heart transplant patient baby Xander

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Before Jennifer Martens had even awoken from her general anesthetic her newborn son had received a new heart.

Xander Dolski underwent one of the rarest pediatric cardiac transplants at Capital Health’s Stollery Children’s Hospital in Edmonton on December 19, 2005.

The family’s journey to beat the odds began in their hometown Winnipeg when the expectant mother went for a routine 20-week ultrasound at Victoria General Hospital.

“The ultrasound technician suspected a mass in the left ventricle,” says Dr. Reeni Soni, head of pediatric cardiology at the Variety Children’s Heart Centre (VCHC) at Winnipeg Children’s Hospital.

Martens was immediately referred to Dr. Geoff Reid, assistant professor of fetal maternal medicine at St. Bonifice Hospital. Tests confirmed the presence of a mass and the baby was assessed for other anomalies.

“It was alarming but didn’t seem to be that big a deal at the time,” says Martens, a first-time mother. “The mass was the size of the tip of a ball point pen.”

Dr. Soni continued to carefully monitor the baby’s progress and performed a detailed fetal echocardiogram. “This assessment confirmed this mass was more complicated than the usual types of masses that are seen in fetal hearts. It was impairing function of the mitral valve causing severe leakage. Follow-up at VCHC revealed this problem was causing secondary problemsÑprogressive obstruction to the left ventricular exit pathway and progressive failure of the left ventricle’s pumping action.”

When Jennifer Martens reached her 34th week of pregnancy, doctors in Winnipeg broke the difficult news. The baby’s heart damage was lethal. The infant would not live more than a few hours unless a heart transplant took place immediately after birth.

That’s when the Western Canadian Children’s Heart Network became involved. The organization includes five centres in Western Canada.It shares clinical knowledge and expertise to improve care for children with heart disease and provides support for these patients and their families. The Stollery Children’s Hospital is one of the network’s referral centres for heart transplants.

The decision was made. The fetus would be placed on a donor list for a heart. Even that proved a challenge.

“Should the fetus be delivered too early, its lungs would not be developedÉ too late and a donor heart may not be available,” according to Dr. Yashu Coe, attending cardiologist at the Stollery Children’s Hospital and professor of pediatrics with the University of Alberta.

At 36 weeks of pregnancy, Jennifer Martens cautiously boarded a plane bound for Edmonton. “At that point I didn’t know if I would be bringing my baby back home to Winnipeg for a baby shower or for a funeral.”

Timing was everything and a week after arriving in Edmonton the fetus was placed on the official cardiac transplant list.

Three days later, at 1:30 a.m., Jennifer Martens received the phone call that would change her life. A heart was on the way and she went to Capital Health’s Stollery Children’s Hospital where Dr. Rhada Chari and Dr. Floria Tsui from the Royal Alexandra Hospital would answer a special request to deliver the baby by C-section in the Stollery’s O.R. to ensure the baby would be on site when the donor heart arrived.

“It was such a mix of emotions,” says the baby’s dad, Walter Dolski. “We were so excited and scared and at the same time we knew that somewhere a family like us was mourning the loss of their baby. It was just so overwhelming.”

Xander Dolski arrived into the world at 4:45 a.m. on December 19th. He weighed 6 pounds, 6 ounces (3 kilos) and measured 19.5 inches (49.5 centimeters). At first, Xander was the picture of a plump, pink, healthy newborn until his heart started to fail rapidly.

“We needed to wait a few hours to make sure that every other organ was working properly. Donor hearts are precious and we don’t want to transplant a heart when a baby may have other lethal problems,” according to Dr. David Ross, Stollery cardiac transplant surgeon and associate clinical professor at the University of Alberta that went on to perform Xander’s operation.

At 8:10 a.m., Xander Dolski was rushed to the operating room, placed on a heart bypass machine and his tiny chest sawed open. Dr. Ross proceeded to transplant the strawberry-sized donor heart.

By the time Xander was eight hours old the transplant was complete.

“This is a remarkable story of team work,” says Dr. Ross. “The quick, accurate diagnosis in Winnipeg, the efforts of the Western Canadian Children’s Heart Network, the obstetricians and the pediatric cardiac team here in Edmonton have saved Xander’s life. Had all of these people not played a role, this beautiful, happy boy would not be with us today.”

Xander Dolski is still under the care of Capital Health’s Stollery Children’s Hospital cardiologist and University of Alberta professor of pediatrics, Dr.Yashu Coe.

He weighs more than ten pounds and is already outgrowing his first clothes.

That’s beautiful news for the Marten and Dolski families back in Winnipeg who have already planned not one, but four baby showers.