At 2 months old, Jacob “Jake” Byrom began turning blue. His oxygen levels plummeted to a dangerous 50-to-60 percent range, far below the optimal 100 percent mark. He was quickly flown from Bakersfield to Children’s Hospital Central California, where Dr. Edwin Petrossian of the cardiac surgery team awaited.
“It was the scariest moment of our lives,” said Jake’s father, Monty.
Jake was born with tricuspid atresia, a life-threatening congenital heart condition in which he has only one functioning heart chamber (the left chamber), reducing the amount of oxygen-rich blood circulating through his body. Most children with this condition require a series of surgeries done in stages over months or years, allowing blood from the body to flow directly to the lungs to pick up oxygen and prevent blood that already has oxygen from returning to the lungs.
As the Byroms would soon discover, their baby was in good hands. One of two dedicated pediatric cardiac surgeons practicing at Children’s Willson Heart Center, Dr. Petrossian has extensive expertise in complex pediatric and congenital cardiovascular surgical repairs. The Willson Heart Center’s cardiac surgery team is part of the Northern California regional congenital heart program affiliated with Stanford University, making the service part of the largest pediatric cardiothoracic surgical program in North America. Each year, surgeons in the program perform over 1,000 cardiothoracic operations.
Dr. Petrossian completed Jake’s first procedure, a bi-directional Glenn, increasing his oxygen levels and allowing more blood from the head and upper limbs to pass directly to his lungs. It also set the stage for the next operation, the Fontan procedure, which would be done later when Jake was a little older.
After the bi-directional Glenn operation, Jake’s oxygen levels increased, but not near normal. As he got older, he used more blood in the lower body and required more oxygen. It wasn’t until he was 2 to 3 years old that his parents began noticing he moved slower than other kids his age.
“I had to carry him places,” said Jake’s mother, Joy. “He was tiring out a lot. The bigger he was getting, the worse it was becoming.”
In 2008, Dr. Petrossian performed the Fontan procedure to raise Jake’s oxygen levels to at least 95 percent. Using a durable plastic tube, Dr. Petrossian essentially created a passageway for oxygen-poor blood from his lower body to travel directly to his lungs for fresh oxygen.
“He was a real trooper, his attitude really helps,” said Dr. Petrossian.
“After this kind of operation, it helps to have a steady disposition. Crying and straining can cause pressure in the chest, which impedes blood going to the lungs. It impacts how quickly patients recover and how well they do after surgery.”
Today Jake’s oxygen level is 96 percent, the average level for children with Fontan operations. That means Jake has more energy and fewer chances for complications. “We noticed an astronomical difference in Jake after his second surgery,” said Monty. “He has a lot more endurance and strength.”
With no planned surgery in the future, happy days are ahead for the 4 year old. “There’s nothing he can’t do but he should pace himself,” said Dr. Petrossian. “He might tire quicker than his peers but that shouldn’t prevent him from doing most things.”
Jake does have potential risks, including the possibility of outgrowing his plastic tube. Dr. John Caton, a cardiologist at Children’s Willson Heart Center, will continue to monitor him.
The family is grateful for Dr. Petrossian and Children’s. “Dr. Petrossian went the extra mile,” said Monty, a musician and real estate agent. “There was never a day he didn’t come meet with us. He never rushed, and answered all of our questions.”