Historic surgery a big win for tiny hearts.

Last fall, something remarkable took place at BC Children’s: for the first time in Canada a tiny, modified pacemaker was placed inside a newborn’s heart. This immediately sparked new hope for babies with severe heart conditions—babies like Jonithin.

When Jonithin’s mother Caitlyn was almost 30 weeks into her pregnancy, physicians in Williams Lake determined her baby’s heartbeat was too slow. The team at their local hospital knew they had to act fast to save Jonithin, so he was delivered prematurely and transported to BC Children’s Hospital by air ambulance.

Caitlyn and her husband Peter were beside themselves with worry, but Jonithin was where he needed to be. Dr. Shubhayan Sanatani, head of cardiology at BC Children’s, had recently received a special exemption from Health Canada to use a modified pacemaker on an infant with a low heartbeat. He had seen it work in the U.S. and was inspired by its potential. “We knew this could save lives like Jonithin’s,” said Dr. Sanatani.
Jonithin easily met the criteria for the exemption: he had a complete heart block. His dangerously low heartbeat was caused by a lack of communication between his heart’s atria and ventricles. To survive, Jonithin’s tiny heart needed an equally tiny pacemaker. Dr. Sanatani reached out to the cardiac surgery team to set things in motion.

The task would be complex, but experts at BC Children’s are equipped to operate on hearts the size of a walnut. What’s more, the world-class cardiac surgery team had recently brought in experts like Dr. Mohammed Al Aklabi, head of cardiac surgery . Dr. Al Aklabi has had a transformational impact on the hospital’s cardiac surgery program. “He’s enabled the delivery of surgical repairs to certain patients where previously there was thought to be no surgical pathway forward,” explained Dr. Erik Skarsgard, surgeon-in-chief at the hospital. “The outcomes have been life-changing for families.” Jonithin’s family would be no exception.

“We knew this modified pacemaker could save lives, like Jonithin’s.” – Dr. Sanatani.

Following a successful surgery, Caitlyn and Peter were overwhelmed with relief: their son could breathe on his own, and for the first time, he was hungry and able to keep food down. He was recovering quickly. At the end of November, Jonithin was cleared to return home to 108 Mile Ranch, where he could finally meet his two older siblings. The family is thrilled to be together in one place.

Jonithin still needs doctors to monitor his heart and pacemaker, and to keep a close eye on him as he grows. “Most of my pacemaker kids I see once or twice a year, and in between that they’re running around, they’re active kids, they’re doing lots of normal-kid stuff,” Dr. Sanatani said. Thanks to this historic achievement, Jonithin will be one of them.

Congenital heart disease affects 1 in 100 babies. Unsurprisingly, the Children’s Heart Centre at BC Children’s Hospital is a very busy place. Dr. Al Aklabi estimates the cardiac surgery team has performed over 500 surgeries in the last two years alone. “Forty of these cases were extremely complex,” said Dr. Al Aklabi. “Previously, those 40 children would have had low chances of survival, or would have lived with significant challenges.”

Much of this progress has been made possible through donors, who have empowered the team with new, critical pieces of surgical equipment, research funding and a dedicated cardiac surgery suite. And with continued support, experts are making mighty strides in advancing care for babies and children with heart challenges. In many ways, Jonithin’s groundbreaking surgery is just the beginning.

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