Methodist Healthcare System | Keeping Well | Summer 2021

6 KEEPINGWELL — SUMMER 2021 Seguin infant with unusually late- diagnosed heart defect reaches major milestones after heart surgery As new parents, Jasmine Venegas and Malachi Rodriguez, rushed their four-week- old son, Malachi, to an emergency room, Jasmine knew in her gut that something was very wrong. In fact, she had that gut feeling since May 5, 2020, the day her son was born. “He would sometimes turn blue,” Jasmine recalled. “I went to his first doctor and saw a nurse practitioner and she didn’t catch anything, but his breathing was always really rapid and he didn’t like to lay flat.” Jasmine says Malachi was not gaining weight and he was a very fussy baby. During a check-up with a new pediatrician on June 2, moments before heading to the ER, Malachi’s lips turned blue and his oxygen level was low. He was fighting to breathe. The pediatrician instructed the Seguin couple to drive Malachi to an ER in San Antonio right away. Shortly after arriving, they learned what was wrong with their son. Malachi was suffering from dextro- Transposition of the great arteries or d-TGA, which is a birth defect of the heart in which the two main arteries carrying blood out of the heart—the main pulmonary artery and the aorta—are switched in position, or “transposed.” “The cardiolo- gist in the ER said that they should’ve caught it a long time ago,” Jasmine said. The Centers for Disease Control and Prevention (CDC) estimates that about 1,153 babies are born with TGA each year. Typically, this condition is caught during pregnancy while the mother undergoes prenatal tests or ultrasounds, or immedi- ately following birth. Pediatric congenital cardiovascular surgeon and Medical Director of the Congenital Heart Program at Methodist Children’s Heart Institute, Dr. John Kupferschmid, says it’s somewhat unusual for a late di- agnosis of d-TGA in America. He sees this situation once every five years. Malachi was transferred from a San Antonio hospital’s ER to Methodist Children’s Hospital for immediate care. “Dr. Olawale Olabiyi said the best place to go was Methodist Children’s Hospital, because Malachi was spiraling. His heart rate was at 200 and his oxygen level was so low,” Jasmine said. Once arriving at the children’s hospital, the cardiac care team, along with Dr. Kupferschmid, assessed Malachi and de- termined he would need an arterial switch operation, but because the infant’s heart defect was not caught shortly after birth, this large operation would be risky. “Think of Malachi’s heart like an adult who’s broken their arm and been in a cast. Once the cast is removed, the arm’s muscle mass has weakened,” Dr. Kupferschmid explained. “Malachi’s heart did not have the muscle mass to go from pumping 20 millimeters of pressure to 80 millimeters of pressure, suddenly.” Because of this, on June 5, Dr. Kupferschmid performed a smaller proce- dure by placing a band and shunt in Malachi’s heart to allow it to gain the strength needed to withstand the larger arterial switch opera- tion, which took place on June 24. “A week after the first surgery, Malachi was smiling more,” Jasmine said. “Once his second surgery came, he was smiling even more and moving.” Malachi responded to the surgeries well. Jasmine says her son is one-of-a-kind and a fighter who was fight- ing for his life since birth. Now, he is reach- ing major milestones, like sitting up by himself at an early age. Malachi Rodriguez and Jasmine Venegas with their son, Malachi