Dr. Julius Golender is used to being asked for help by East Jerusalem’s Red Crescent Hospital, since the medical center lacks a pediatric cardiology ward — his area of expertise.
But when he received an urgent call last month, it was clear that “this was a complicated case,” he said.
On February 14, a Filipino baby boy, Francis Joseph, was born at the Red Crescent Hospital with a rare and serious heart defect, which threatened to kill him within hours if it went untreated.
The baby needed a complicated and risky open-heart surgery known as the Jatene procedure, which the East Jerusalem hospital did not have the necessary facilities to perform but which was possible in Golender’s Hadassah Hospital in the capital’s Ein Kerem neighborhood.
Could he help out?
The baby was born with a condition known as transposition of the great vessels, or TGV, in which his arteries were not properly connected to his heart and, in his case, the openings to the heart chambers were also malformed. They were so small that they were preventing his blood from being pumped throughout this body.
His mother Nina, a 41-year-old foreign worker from the Philippines, wasn’t aware that her baby would be born with this defect and so the delivery room doctors were unprepared when they saw he had breathing problems, a weak pulse, and blue skin color from a lack of oxygen. She gave permission to the hospital to discuss her son’s case, but asked to be identified only by her first name.
After speaking with a Dr. Nasser at the Red Crescent Hospital, Golender consulted with his fellow pediatric cardiologists from Hadassah, Dr. Juma Natshe and Dr. Sagi Gavri, who helped him come up with a plan of action.
First, they would have to stabilize the baby’s condition by performing a procedure known as a cardiac catheterization, in which a tube would be inserted into Francis Joseph’s malformed heart valve in order to allow oxygen-rich blood to flow from the lungs to the rest of the body.
Only then they would be able to move the baby from the Red Crescent Hospital to Hadassah in order to perform the open-heart surgery necessary to correct the transposition of the great vessels. The Jatene procedure is named for its creator, famed Brazilian cardiologist Dr. Adib Jatene, who first performed it successfully in 1975.
The three doctors received permission from hospital management and quickly traveled to East Jerusalem, where the hospital had already prepared the delivery room for the emergency catheterization.
The doctors explained the nature of the baby’s defect and the procedures required to correct it to his mother, Nina, who was understandably distressed, having just given birth.
“I was surprised when suddenly these experts from Hadassah showed up at the Red Crescent Hospital, and in my view it was a miracle,” said Nina.
The cardiac catheterization was successful and the baby’s condition started to stabilize, but the doctors needed to wait a day before he could be moved.
“We did everything we could possibly do so that it would be possible to perform surgery on the newborn baby in Hadassah and fix the heart defect that he was born with, which had caused this extremely complicated medical condition,” said Sagi, soon after the catheterization.
The next day, Francis Joseph was transferred to Hadassah and cardiothoracic surgeon Prof. Eldad Erez began the Jatene procedure, in which he detached the improperly connected arteries and veins and then reattached them in the proper configuration.
The successful surgery took a little over five hours, according to the hospital.
The baby’s condition began to stabilize and he was moved to the hospital’s intensive care unit.
After the surgery, Erez left the baby’s chest open in order to leave room for any swelling and to make it easier for doctors to have access to his heart in case there was any need for additional operations. This was not the result of any specific complication, but is a standard part of the Jatene procedure.
It’s not something that my team and I encounter on a daily basis, but we had no intention of giving up
On February 16 — two days after he was born– Francis Joseph’s chest was sewn closed.
Erez said the baby’s condition was exceedingly rare. “It’s not something that my team and I encounter on a daily basis, but we had no intention of giving up.”
Nina thanked the doctors and the hospital for stepping in and performing the life-saving surgery on her son. “We were undoubtedly very lucky that Hadassah got involved and saved my child and my family,” she said.
A few weeks after the surgery, Francis Joseph was released from the hospital and allowed to go home.
He returned to the hospital this month for a checkup.
His doctors say he is “in good condition, active and smiley.”