Aortic Valvar Stenosis: Heart Catheterization Saves Matthew
"It's everybody here that makes the difference."
Matthew Emmerling at Cincinnati Children's shortly after he was born.
"It was so horrifying seeing him like that. That was the hardest part of the whole thing. Not being able to touch him or pick him up. He had so many wires and machines attached to him."
Joe Emmerling, Matthew's Father
Shortly after birth, Matthew Emmerling was diagnosed with aortic valvar stenosis -- a condition that causes obstruction to blood flow in the heart between the left ventricle and the aorta. At just 3 days old, Matthew underwent a cardiac catheterization to save his life. Today, thanks to the technology in the new Hybrid Cardiac Catheterization Laboratory at Cincinnati Children's, Matthew is a happy and healthy 17-month-old who enjoys running and playing swords with his older brothers.
"We considered ourselves to be seasoned parents," says Joe. "Some stitches, tonsils need to be removed, no problem." But nothing could prepare Joe and Sarah Emmerling for what they were about to face with their newborn son, Matthew.
Joe and Sarah live on the west side of Cincinnati with their four sons: Nick, 7; Leo, 5; Dan, 3; and Matt, 1. Matthew was born on December 27, 2005, at Good Samaritan Hospital in Cincinnati, Ohio. Matthew seemed to be a very happy and healthy little boy. But when the night nurse at Good Sam came in to check him, she heard something in his heart, possibly a murmur. The nurse contacted the Emmerling's doctor who heard the same sound. Joe and Sarah were told that it may just be Patent Ductus Arteriosus (PDA), which occurs in 15% of children. They were advised to have their family doctor check Matthew in a few days.
The ductus arteriosus is a small tube the baby uses to breathe while still in its mother's womb. After the baby is born and starts to use its lungs to breathe, the ductus arteriosus closes on its own. In some cases, however, the ductus arteriosus remains open, causing more blood to flow into the lungs than normal. This condition is called Patent Ductus Arteriosus (PDA).
A Frightening Beginning
A couple of days after Matthew came home from the hospital, Joe and Sarah noticed that Matt's feet were cold. When Joe touched one of Matt's toes, he noticed that his refill rate was slow. (The pigmentation in his toe didn't return to pink very quickly.) Joe and Sarah took Matt immediately to their family doctor, who listened to his chest and did hear a murmur.
The Emmerling's family doctor called Cincinnati Children's Hospital Medical Center and spoke with Robert H. Beekman, III, MD, professor of pediatric cardiology at Cincinnati Children's. Dr. Beekman got Matthew in that day for an echocardiogram. "The echo ended up taking two hours," says Joe. "We knew something was wrong because they kept focusing on one particular part of this heart: the aortic valve."
Robert Beekman, MD, director, Cardiology, with Matthew, Sarah and Joe Emmerling in the new Hybrid Cardiac Catheterization Laboratory at Cincinnati Children's.
A Closer Look at the Hybrid Cardiac Catheterization Laboratory
The Hybrid Cardiac Catheterization Laboratory provides highly sophisticated treatment for infants and children with serious heart defects.
Facts to know:
- It is one of a few such facilities at a pediatric hospital in the US.
- It allows all-in-one room care, including simulataneous catheterization and surgery.
- It allows sophisticated diagnostic tests and a full range of therapeutic procedures to be performed in the same place, including the placement of stents and pacemakers.
- The patient is able to stay in one place, where all the technology that might be needed is already located and cardiac catheterization specialists and surgeons come to the patient.
- The lab is among the first in the nation to provide real-time communication between the lab and other cardiac specialists throughout the hospital.
Advice from the Family
Joe and Sarah Emmerling offer this advice to other families facing the same situation: "Come here, period. There is no other choice."
Surgery at 3 Days Old
Diagnosed with aortic valvar stenosis, Dr. Beekman told the family Matt was critical and needed surgery first thing in the morning. Matt was just three days old. (Aortic stenosis refers to a condition that causes obstruction to blood flow between the left ventricle and the aorta.)
"This was nothing we were ready for," says Joe. "It didn't really hit home until we started calling everybody to take care of the other boys. It was overwhelming."
The next morning Matt underwent a cardiac catheterization at Cincinnati Children's. During this procedure, a catheter is inserted to take measurements and pictures of the heart. After the measurements are taken, a balloon is inserted to gently open the valve and relieve the obstruction. "Up until that prior morning, Matt seemed like a normal, healthy baby. Then he deteriorated quickly," Joe says. "It was so horrifying seeing him like that. That was the hardest part of the whole thing. Not being able to touch him or pick him up. He had so many wires and machines attached to him."
The procedure went very well. The doctors at Cincinnati Children's were able to balloon and relieve the valve stenosis, and Matthew was able to go home with his family just six days later. Joe and Sarah knew that Matt would eventually need valve replacement surgery but they and the medical team wanted to hold off as long as possible. "The only way we're able to wait to do that is with this cath lab," says Joe. "The prognosis is very good."
An Unexpected Trip to the Emergency Room
In January 2006, Joe and Sarah discovered blood in Matthew's stool and brought him into the Emergency Room at Cincinnati Children's. Matthew was diagnosed with an ulcer, which is sometimes seen in children with serious heart conditions. "Matthew was being treated by GI [Gastroenterology] but the Heart Team knew we were here," says Joe. "They saw him as much as the GI team."
Matthew stayed in the hospital for eight days to undergo treatment for the ulcer. "They kept close tabs on him because of that [Matt's heart condition]. It made a difference," says Joe.
Second Catheterization Brings Good News
In January 2007, Matt underwent his second cardiac catheterization. This procedure was performed in the new Hybrid Cardiac Catheterization Laboratory at Cincinnati Children's -- one of few such facilities at a pediatric hospital in the United States. The Laboratory allows for sophisticated diagnostic cardiac tests and a full range of invasive therapeutic procedures -- even cardiac surgery -- to be performed in the same laboratory.
During this second catheterization, Joe and Sarah were prepared for Matthew to have another balloon inserted into his heart. However it was not necessary because the aortic valve was working well. "The equipment here was able to tell them they didn't need to do another balloon," says Joe. "Without this technology, they may have done the balloon anyway." Because of the success of the first heart catheterization, the Emmerlings are able to put off Matt's heart valve replacement until he's a little older, possibly 2 years old.
"It's everybody here that makes the difference," says Joe. "You get the overall feeling that there isn't anyone here that doesn't care."
Matthew Emmerling in the Hybrid Cardiac Catheterization Laboratory at Cincinnati Children's.
A Bright Future
Matt continues to be seen quarterly by Dr. Beekman and the Heart Center team at Cincinnati Children's and is doing well. He enjoys running and playing swords with his older brothers. Nick, Leo and Dan also enjoy pushing their baby brother around on a Winnie the Pooh toy but their favorite pastime is "What will Matt eat now?"
Related Services
Heart Center
Cardiology
Gastroenterology, Hepatology and Nutrition
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