Heart operation saves Honduran baby's life

By NELLIE KELLY World Staff Writer
3/11/2001

A new lease on life


Gloria Valladares (above) kisses her son, David Fonseca, following the baby's emergency surgery at St. Francis Hospital. Dr. Richard Ranne (at right) examines the 7-month-old Honduran boy, who was on his way to the Mayo Clinic when he went into cardiac arrest.
DAVID CRENSHAW/ Tulsa World

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Trauma teams call it the "Golden Hour" -- 60 precious minutes between when patients need care and when they arrive at an emergency room.

Doctors, nurses and paramedics hustle to help a person before time runs out.

When an emergency happens in midair, the minutes tick away even faster.

That was the situation a Honduran mother faced Feb. 6 when her 7-month-old son went into cardiac arrest on an airplane. They had flown into the United States in Houston and were on their way to the Mayo Clinic in Minnesota for a free surgery to fix the infant's heart defect.

Little David Fonseca turned purple, stopped moving and didn't cry. His mother, who speaks only Spanish, didn't know what to do, so she shook the person sitting next to her until he

realized her problem.

The man summoned flight attendants, who hooked the baby up to an oxygen mask and asked if any doctors were aboard. Two came forward.

They took the baby away to perform cardiopulmonary resuscitation. The rest of the flight is a blur to Gloria Valladares, who still cries when she thinks about the terrifying situation.

"I asked whether they could go all the way to Minnesota because I knew the operation was going to be free at the Mayo Clinic," Valladares said through an interpreter. "But they said he needed help immediately."

The plane, already an hour past Houston, made an emergency landing in Tulsa -- the nearest city with a children's hospital. On the ground, pediatric cardiologists, intensivists, emergency physicians and ambulance personnel prepared to handle the baby.

An EMSA ambulance met the plane at the Tulsa International Airport and rushed the baby to St. Francis Hospital.

Dr. Richard Ranne, a pediatric surgeon, called Mayo doctors to discuss the case. Since birth, David had suffered a heart condition in which the pulmonary vein didn't connect the lungs to the heart. When blood entered the lungs to get oxygen, it had no pathway back to the heart, Ranne said.

The problem usually is diagnosed and fixed within a newborn's first month in the United States. When David was born, Honduran doctors detected no problems. Two months later, Valladares knew something was wrong because the baby slept too much, lost weight and couldn't breathe properly.

The problem was diagnosed in Honduras, but without humanitarian efforts in the United States, it would have gone un fixed because no doctor in the country had the know-how to perform the surgery. Then an American missionary helped 40- year-old Valladares find help in America at the Mayo Clinic, a premier medical facility.

"I was afraid," Valladares said of landing in Tulsa. "But I thought they could help him enough that he could still go to the Mayo Clinic."

Instead, St. Francis agreed to handle the case as charity. Ranne performed the same operation that was scheduled in Minnesota.

To reduce blood flow during the surgery, Ranne put the baby into circulatory arrest by cooling him to about 60 degrees.

"It's sort of a state of suspended time," Ranne said.

The pulmonary vein is located in the back of the heart, so Ranne entered the chest, pulled out the heart, connected the vein and replaced the heart.

Ranne calls the operation "totally successful." Now the baby has a healthy heart and lungs that are connected properly.

"This was like a pop quiz for the Tulsa medical community," Ranne said. "And the medical community received an A-plus."

The baby's situation wasn't the first time doctors at St. Francis have come to the rescue of a foreign child. Each year since the mid-'90s, doctors have brought two children from war-torn Bosnia to Tulsa for surgery.

Churches, the community and St. Francis coordinate the effort, Ranne said. Volunteers, such as Nancy Cook, Euridice Williams and translator Socorro Robertson, have served as hosts.

"It makes you feel good that your team can help out," Ranne said. "But it makes you realize there are probably 10 who need the same care, but because of medical or social reasons never get it."

David Fonseca was one of the fortunate few who found help even though he was born with a rare disease in a country that could not cure him.

When Valladares returns to Honduras with her baby later this month, she'll take with her memories of Tulsa -- the town she had never heard of that helped her in a time of need.

"When people heard Dr. Ranne would do the surgery, they encouraged me by saying what a great doctor he is," Valladares said. "He will forever be in my heart."