FEATURE | Posted Nov. 3, 2014

Healing the tiniest hearts

UC Davis Pediatric Heart Center offers lifesaving expertise close to home

Xavier Smith and mom Jessica Mendoza © UC Regents
Xavier Smith, here with mother Jessica Mendoza, was barely 10 days old when he underwent his first life saving open-heart surgery at UC Davis Children's Hospital to correct a congenital heart defect.

Major cardiovascular surgery is usually the concern of an aging adult, not a newborn baby with a heart the size of a strawberry.

Yet that’s exactly the challenge that tiny Xavier Smith faced just days after coming home from the delivery room.

Mom Jessica Mendoza had experienced a normal full-term pregnancy, and no one expected problems for Xavier. But soon after her release from the community hospital in rural Colusa, Calif., 22-year-old Jessica and her mother noticed that the baby wasn’t eating or breathing as well as he should be.

Doctors at the local hospital consulted UC Davis experts, which led to an air ambulance ride to the Pediatric Heart Center at UC Davis Children’s Hospital. There, UC Davis specialists diagnosed a rare congenital heart defect that had been undetected during pregnancy.

"I’d never heard of congenital heart defects before. I was told not all babies survive through open-heart surgery with the disease that Xavier had.”
– Jessica Mendoza

The condition, known as hypoplastic left heart syndrome, leaves one side of the heart severely underdeveloped and can lead to massive organ failure within the first hours or days of life.

That process had already begun for Xavier. At just 10 days old he entered UC Davis pediatric cardiothoracic surgeon Gary Raff’s operating room for the Norwood procedure, the first of a three-step surgical series to rebuild his heart and restore proper circulation of oxygen-rich blood to his body.

“I was scared and nervous – I didn’t know what any of this meant as far as what was going to happen to Xavier,” Jessica said. “I’d never heard of congenital heart defects before.

“I was told not all babies survive through open-heart surgery with the disease that Xavier had.”

First program in inland Northern California

Surgeon Gary Raff © UC Regents
Gary Raff is one of an elite corps of highly skilled pediatric cardiothoracic surgeons who are able to perform complex surgeries on some of the tiniest and most fragile patients.

UC Davis Children's Hospital provides complex specialty and trauma services across a huge swath of the north state and the Central Valley, and had expanded its pediatric heart program in 2008 better serve patients like Xavier closer to home. The hospital's Norwood program became the first in inland Northern California, and the procedure itself one of the most specialized that UC Davis Health System performs.

To correct hypoplastic left heart syndrome, surgeons reconstruct and reconfigure parts of the heart and cardiovascular system in a way that allows the child to grow and thrive. Because repairing the defect requires an initial hospital stay of several weeks, return visits for follow-up care and the two additional surgeries, accessing treatment locally can ease stress on the child and family. 

UC Davis also offers advanced facilities and technology to support such delicate procedures, including a new state-of-the-art Pediatric Cardiac Intensive Care Unit (PCICU) that is staffed by personnel dedicated solely to the care of infants and children with congenital or acquired heart disease.

Progressing well

“I think his care has been outstanding – all of the doctors are wonderful and do a great job of making sure I understand everything that goes on.”
– Jessica Mendoza

Xavier recovered well from the first Norwood surgery and the second, a shunting procedure at three months of age. The third and final in the series, the Fontan procedure, will take place this fall.

“I think his care has been outstanding – all of the doctors at UC Davis are wonderful and do a great job of making sure I understand everything that goes on,” Jessica said. “He is progressing very well and doing things other kids his age are doing.”

When she’s not handling health appointments between Xavier’s surgeries, Jessica finds empowerment during the wait by helping to educate the public about congenital heart defects, in hopes they can be detected as early as possible. Earlier this year, she convinced her hometown city council to declare Congenital Heart Defect Awareness Week around Valentine’s Day.

“Before this happened to me, I had no idea about this ‘heart’ world that I’m in now – and it can happen to anyone else,” Jessica said. “I almost lost Xavier, so if we could make people aware maybe they can catch it during pregnancy instead of it all happening in a matter of minutes or hours.”

Comprehensive care

To learn more about the cardiovascular and other specialty services offered at the region’s only nationally ranked comprehensive hospital for children, visit children.ucdavis.edu.

Meanwhile, Xavier is active enough that it can be difficult for a newcomer to tell he has heart issues at all. He tends to tire faster than other kids, but otherwise his condition isn’t obvious.

“He loves to play and walk around outside,” his mother said. “He likes to watch football and basketball on TV, and he is already really into electronics.”
In other words, typical stuff for any healthy young guy.