Dario is a chatty fifth grader who likes playing video games and has a keen interest in natural disasters. When he was born, his esophagus was incomplete. Surgery at Cincinnati Children’s has allowed him to enjoy eating foods by mouth, which he previously wasn’t able to do.
Dario Zapata was born with esophageal atresia, one of many birth defects that eventually resulted in a diagnosis of VACTERL association. Esophageal atresia occurs when the esophagus does not fully form and fails to connect the mouth to the stomach. It causes both breathing and feeding problems.
After three surgeries elsewhere to treat his esophageal atresia, Dario’s parents, Isain and Ileana, brought Dario to Cincinnati Children’s for a second opinion when he was 7 years old. “Cincinnati Children’s had a very unified team with several specialists in the Aerodigestive and Esophageal Center,” Ileana says. “Also, good communication with the team was very important to me, and we found that here. I was able to get in touch with someone any time we had a question.”
Here, at ages 7 and 8, Dario underwent two additional surgeries to repair his esophageal atresia, both with Daniel von Allmen, MD, leading the team. “Esophageal surgery is not ‘one procedure fits all.’ We study each child and their physiology to determine the best approach to take,” says Dr. von Allmen, a pediatric surgeon who has been with Cincinnati Children’s since 2009.
For Dario, his esophageal tissue was damaged and very delicate. His first surgery here was very challenging and the year after was full of complications. Dario’s care team and the Zapatas continued to work together to find a solution that would be successful for Dario.
During his most recent surgery, our surgeons cut out the damaged portion of Dario’s esophagus and reconnected it. “That went beautifully,” his mom says. “He spent less than 10 days in the hospital and recovered well. When we went home, he started eating afterwards. That was the first time in his life that he was able to eat by mouth safely.”
Finding the Right Treatment
While these types of surgeries can be complicated and challenging, Dr. von Allmen and the Aerodigestive and Esophageal Center team at Cincinnati Children’s have the expertise that it takes to be successful. “Finding the right treatment involves looking at the child, the history, the anatomy, and his specific circumstances and then working with the family to come up with the right solution. That’s what our team does. It’s a very individualized process,” Dr. von Allmen says.
Dario’s esophagus troubles have been eased ever since that surgery. Just three years ago, he was in and out of the hospital every week or two for emergency dilatations when doctors needed to stretch a narrowed portion of his esophagus. Now he’s able to go several months without returning for a check-up.
“He’s improving slowly but steadily,” Ileana says. “He still has some issues with eating, but he is eating 25 percent of his meals by mouth.”
That progress is allowing Dario to have fun being an 11-year-old kid. He’s a curious fifth grader with a head full of dark hair and an impressive knowledge about natural disasters, science and human anatomy. He’s also personable, and has made friends with many of the staff members in various departments throughout the medical center.
Taking Things a Day at a Time
Dario’s journey is a long and complex one. Dr. von Allmen is not his only doctor. He sees several other specialists for management of additional medical conditions he was born with. But the Zapatas are grateful to Cincinnati Children’s for having his esophageal atresia under control.
“We have to take it one day at a time,” Ileana says. “He has had fewer issues with aspirations and pneumonia since his last surgery. It’s very reassuring that he hasn’t needed another major surgery in the past two years.”
Her husband chimes in, noting the complexity of his son’s medical care. Says Isain, “The level of care that Dario needs cannot be standardized. We have found the team here very well prepared to handle that.”