A New Heart for Christian

Ruth Dinh; Michael Macris, M.D.; Brenda Merkelz; Clarissa Ortiz; Biswajit Kar, M.D.; Christian Dinh; Sriram Nathan, M.D.; Bindu Akkanti, M.D.; Indranee Rajapreyar, M.D. Not pictured: Pranav Loyalka, M.D.; Igor Gregoric, M.D.
Ruth Dinh; Michael Macris, M.D.; Brenda Merkelz; Clarissa Ortiz; Biswajit Kar, M.D.; Christian Dinh; Sriram Nathan, M.D.; Bindu Akkanti, M.D.; Indranee Rajapreyar, M.D. Not pictured: Pranav Loyalka, M.D.; Igor Gregoric, M.D.

A healthy, athletic teenager, Christian was used to physical challenges. He had been a decorated swimmer and played basketball, baseball, football and soccer most of his life. During a family vacation in Colorado in August 2014, he and his family were faced with the greatest challenge of his young life.

Christian began experiencing flu-like symptoms – fever, cough, difficulty breathing and chest pain, all of which worsened over the next five days.

“I took fever medicine, cough medicine and didn’t worry.  I don’t remember ever being sick.  I thought I was invincible,” Christian says. “The next day I woke up and I knew something was absolutely wrong.”

The family headed back to Houston early. His dangerously high fever and pale complexion worried his aunt Ruth, an ICU nurse at Memorial Hermann Memorial City Medical Center. On Sept. 5, she took him to the ER at Memorial Hermann Southwest Hospital. Doctors there detected an abnormal heart rhythm, as if he were having a heart attack, but a coronary blood flow study called an angiogram showed no blocked vessels.

His symptoms worsened and tests showed his organs were failing. “His color was terrible, he was short of breath and he had a markedly abnormal heart rhythm and low blood pressure,” says Michael Macris, M.D., a cardiovascular and thoracic surgeon affiliated with Memorial Hermann. “It’s like when you look at a wilting plant. He was dying.”

Dr. Macris diagnosed Christian with fulminant myocarditis and had him transported by Life Flight® to the Center for Advanced Heart Failure at Memorial Hermann Heart & Vascular Institute-Texas Medical Center.  There awaited the team assembled by interventional cardiologists Biswajit Kar, M.D., Pranav Loyalka M.D., and cardiothoracic surgeon Igor Gregoric, M.D.

Fulminant myocarditis is a rare, virus-caused inflammation of the heart muscle that can turn deadly quickly.

“Fulminant myocarditis destroyed his heart muscles,” says Dr. Kar. “This is an extremely serious and catastrophic problem with 80 percent mortality. We could keep him alive due to cutting-edge technologies and expertise available at our Center.”

Christian underwent five hours of surgery to install a tandem heart. The device bypasses the actual heart, pumping blood directly into the body’s largest vessel, the aorta, to give the ailing heart a chance to heal. When the procedure finished at midnight, the team stayed with Christian in the recovery room till 4 a.m., willing him to live.

Over a week passed and Christian had not improved. He was still on full life support. On Sept. 16, Dr. Gregoric’s team replaced the tandem heart – to avoid complication risks – with a biventricular assist device (Bi-vad) to aid both sides of the heart. The Bi-vad has two pumps, one placed on the lower left side of his heart and another above it to pump blood directly to the pulmonary artery and the lungs.

Bindu Akkanti, M.D., a pulmonary and critical care physician affiliated with Memorial Hermann, was among those who stood vigil on the fifth floor of the Institute. “Nurses came in on their days off to spend time with him. Their kids would make him videos and pictures. Our unit has adopted him forever.”

Despite blood clots and an erratic heartbeat, Christian held on. His case went before Memorial Hermann’s medical review board to determine whether he was a candidate for a heart transplant. Given his youth, determination, former healthiness and support of a resilient extended family, Memorial Hermann added him to the transplant list on Oct. 7. Fortunately for Christian, his age and size enabled him to be on lists for children and adults.

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Less than 40 days after he was hospitalized, Christian got a new heart. Four days later, he was removed from the breathing tube and began walking. And four months later – a week before Christmas – Christian was released. The entire transplant team of doctors, nurses, physical therapists, dietitians and pharmacists held a party in honor of their youngest transplant patient.

“At first I asked,’Why me?’ It took me by surprise. It was very hard since I’d always been a healthy, active athlete,” says Christian.  “But my grandmother always believed I would make it. When I doubted it, I remembered what my coaches would say, ‘Try harder and you’ll prosper.’ I wanted to beat whatever was going on with my body.”

Although Christian’s saviors will never know what the original virus was that inflamed his heart, they accomplished three medical miracles.

“The first was to give him every chance to recover from the viral illness, the second was a heart transplant and the third was when he came off dialysis and was able to have full kidney function despite having been on an artificial kidney machine,” says Dr. Macris. “That is rare.”

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“My friends and I used to joke about the motto we’d see in videos: YOLO: You Only Live Once,” Christian says. “Now it has deeper meaning. When I was in the hospital, I had little goals – like make it to Christmas.”

After his experience, Christian hopes to become a pediatric physical therapist.

“My biggest achievement ever was seeing my 18th birthday,” says Christian, who reached that benchmark in August 2015. “I didn’t ask for any presents. Every day is a gift.”

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Christian is alive today because of someone’s decision to be an organ donor.  To learn more about organ donation, visit www.organdonor.gov

To learn more about Memorial Hermann transplant programs, visit Memorial Hermann Transplant Center.

Tashika Varma