Katherine Aristizabal Navia is a happy and healthy 7-year-old. She loves Barbie dolls and wants to be a model. She is her mother’s “miracle baby.” Looking at her, it would be hard to imagine that just a few months ago she underwent a complicated double-switch procedure.
During the heart surgery at Levine Children’s Hospital, Andrew Bensky, MD, said the surgical team redirected veins draining the lungs and body back to the heart into the opposite pumping chamber. Arteries leading from the pumps to the lungs and body were switched. The coronary arteries were moved as well.
“Dr. Bensky is the best,” said Jessica Aristizabal, Katherine’s mom. “He and Dr. Peeler were awesome. They explained everything and took great care of her.”
Doctors at Levine Children’s Hospital discovered Katherine’s congenital heart lesion prior to birth. She was diagnosed with an extremely complex lesion, L-transposition of the great arteries (l-TGA) with Ebsteins malformation of her systemic tricuspid valve. Because of this anatomic arrangement, it was felt that Katherine would eventually be best served by a double-switch procedure.
Katherine’s mom remembers her daughter’s first surgery at age 4, in which a pulmonary artery band was placed, and then the second at age 5 when the band was tightened.
Her morphologic left ventricle had been doing the easier work of pumping to her lungs for several years, so it had to be prepared for the double switch. This was accomplished by placing a pulmonary artery band to raise the left ventricular (LV) pressure. After a year, the band was tightened to continue the training of the ventricle. As the LV pressure increased, the interventricular septum moved toward the right ventricle, reducing the tricuspid insufficiency.
After echo and MRI suggested that the LV had thickened appropriately, the double switch was performed. The pulmonary veins were routed to the mitral valve, and the systemic veins were routed to the tricuspid valve (a Senning procedure). The great arteries were switched, and the coronaries were transferred (an arterial switch procedure). Katherine has done very well since surgery, with good LV function and mild tricuspid insufficiency. This successful operation restored the normal blood flow through the ventricles.
Dr. Bensky said that Katherine has returned to a normal activity level. Besides dolls, Katherine likes the second grade and loves her big brother.
“The nurses at the hospital were great,” Jessica said. “It was a very hard experience. But Katherine did great, and she’s doing great. She’s a beautiful little girl.”