Getting Gabriel well
May 4 2017, 3:50 pm

When Jacqueline Keymer went for her 18 week antenatal sonogram, the technician shared some startling news: she “couldn’t find the baby’s great arteries” with the ultrasound.

Subsequent scans confirmed that little Gabriel would be born with congenitally corrected transposition of the great arteries, a rare condition in which abnormal development of the foetal heart during the first eight weeks of pregnancy causes the large vessels and ventricles that carry blood from the heart to the lungs to switch position.

Normally, this condition sees the two large vessels switched, which creates two ‘closed circuits’ for blood flow: one that circulates oxygen-poor blood from the body back to the body, and another that recirculates oxygen-rich blood from the lungs back to the lungs.

In Gabriel’s case, his body self-corrected the condition by transposing the ventricles. This means that his left ventricle sits on the right side of his heart and his right ventricle sits on the left. Therefore the stronger left ventricle, which is designed to give the blood a strong push out to the body, does the smaller job. The weaker right ventricle, which is designed to give the blood a gentle push to send it to the lungs, has to work much harder and deal with more blood pressure than it’s built for.

“I’m pragmatic, so my first instinct was to learn everything about CCTGA,” said Jacqueline. “I’m sure I was driven by a little thread of fear, but knowledge dispels fear, so I began to arm myself with the facts. The heart is so unique and we so strongly associate it with love, so I really needed to understand how Gabriel’s heart was going to work.”

Just before he turned three years old, Gabriel has his first of three open heart surgeries to correct his condition and help his heart pump blood efficiently.

“I remember that we were almost impatient to get Gabriel’s first surgery underway. At that point Gabriel was still doing relatively well and we didn’t want his health to deteriorate and jeopardise this or any future operations. I know it doesn’t sound right to want your child to have surgery, but with his right ventricle failing, it wasn’t really an option to wait.”

During Gabriel’s most recent operation, cardiac surgeon Associate Professor Christian Brizard corrected the plumbing of Gabriel’s heart, swapping the inflow and outflow vessels so they are connected to the correct chambers.

During this surgery the Finnan’s Gift supported Karl Storz Vitom and Camera System was used. A/Prof Brizard plans to use the images from Gabriel’s surgery in future presentations at conferences when presenting on the diagnosis of transposition of the great arteries. These images will help to train up and coming surgeons across Victoria, Australia and the world.