4 groups work to repair child's heart

WASHINGTON, Aug. 15 (UPI) -- Four charitable organizations teamed up to repair the heart of a Palestinian child, who received the latest care at the Children's National Medical Center here, on Thursday.

Falastin Mouhammad Ali, who will turn 2 on Aug. 26, was resting comfortably Thursday afternoon after undergoing a state-of-the-art cardiac catheterization in Children's new digital catheterization lab. The procedure closed a hole in the wall of her heart's upper chambers.

Falastin, from the West Bank city of Ramallah, was accompanied by her mother, Karima Ali, 37.

"Four relief organizations have networked together from totally different backgrounds to take care of this child," said Barbara J. Zackheim, Director of Development, Save a Child's Heart Foundation, U.S.

"We've got the Palestine Children's Relief Fund, based in Kent, Ohio, taking care exclusively of Palestinian Children. You've got Gift of Life, which is a Rotary Club project based here in the United States. Then we have Save a Child's Heart, which takes care of kids from 15 different countries, and this is our first time doing a procedure in the United States. And then you have the Larry King Cardiac Foundation, which supports Children's National Medical Center, which has never worked with any of the other organizations before. So it's an interesting coalition of organizations throwing in money, resources, volunteers -- whatever it takes to care for this child," Zackheim told United Press International.

Falastin is the youngest of eight children. "She is an absolutely precious little girl," Zackheim said.

As the procedure began Thursday morning, Karima Ali emerged from the catheterization lab with tears in her eyes. The tiny child, whose growth has been stunted by her condition, was hard to spot on the operating table under a sea of blue hospital sheets. Only a few inches of her face were visible.

Many children who have undergone this procedure have shown dramatic improvement in a relatively short period of time, Zackheim said. They lose their chronic fatigue, their blue lips turn a normal shade, and they run about happily.

Falastin and her mother were guests at the Ronald McDonald House in Washington during their stay.

Through an interpreter, Karima Ali said she was grateful to be in a hospital such as the Children's National Medical Center. "I am very impressed with the facility and the doctors, and I have faith that they will help my daughter," she said during the procedure.

About a month after Falastin was born, her mother noticed that the baby was sneezing and coughing constantly. Karima Ali took Falastin to a series of doctors who didn't know what was wrong with the child. It wasn't until Falastin was 7 months old that a specialist diagnosed an atrial septal defect, or hole in the wall separating the upper chambers of the heart, and said that the baby would need special surgery that was not locally available. Karima Ali planned to sell her belongings or get loans to take Falastin to Jordan when she learned about the charitable organizations that are helping her now.

Ali said she learned about the Palestine Children's Relief Fund through a pediatrician in Ramallah. "I am thankful to the fund for having brought me here and cooperating with the other humanitarian groups to make Falastin's trip here possible," she told UPI.

Ali was happy to be able to choose cardiac catheterization over open-heart surgery, in part, because it would leave no scar. "I was very relieved that the recovery time would be short and that Falastin would avoid the potential complications of open-heart surgery," she said. "The first thing I did was to call Falastin's father. What I told him put him more at ease."

Michael Slack, M.D., the interventional cardiologist, headed the team of about eight persons.

Gerard Martin, M.D., chief of cardiology, said congenital heart disease is the No. 1 birth defect in children, affecting nearly one in 100 live births. The most common abnormalities are septal defects, or holes that allow blood to move from one side of the heart to the other and increase the blood flow to the lungs. They occur in about half of children with heart disease. Holes between the ventricles, or lower chambers, are most common. Holes between the atria, or upper chambers, are second most common. Falastin was born with this condition.

In the past, this required open-heart surgery. This operation normalizes blood flow to the lungs, protecting them from damage and the frequent infections Falastin has suffered. It also averts heart failure and rhythm abnormalities. Open-heart surgery gives excellent results, Martin said, but it keeps children in the hospital for three days. It involves some pain and scarring and exposes the patient to blood products and the need for the heart-lung machine. All these things have "some deleterious effects," the doctor said.

With the new Amplatzer Septal Occluder, the hole can be closed without the drawbacks of open-heart surgery. The patient experiences no pain, and the hospital stay is only one day. A catheter is passed up from the veins in the leg, through blood vessels and through the hole in the heart walls.

Martin demonstrated the way the occluder works by passing it through a hole in a sizing grid. Once through, a wire mesh disk a little bigger than a quarter fanned out. Another disk fanned out on the near side of the hole. In the heart wall, the two disks are drawn together on either side of the septum, closing the hole, and the catheter wire is unscrewed and withdrawn. As the child grows, heart tissue grows over the implants, which become permanently sealed.

Not all holes can be closed with such devices, Martin explained. Surgery still is necessary in some cases.

Martin said Children's National Medical Center has served almost 20 patients during the past three years who have been sponsored by the Larry King Cardiac Foundation. "Our relationship with Save a Child's Heart and with Gift of Life is a little bit newer."

Save a Child's Heart Foundation is based at the Wolfson Medical Center in Holon, a southern suburb of Tel Aviv. It came into being in 1995, when an Ethiopian physician requested urgent assistance from Dr. Amram "Ami" Cohen for two children in desperate need of heart surgery. Cohen, a U.S. Army surgeon who had emigrated from Maryland to Israel with his family in 1992, created a team to provide heart surgery and follow-up care for children from Third World and developing countries.

Patients ranging in age from infants to adolescents come from all corners of the world to receive treatment at the Wolfson Center. The SACH staff, some 70 in all, substantially volunteers its services. SACH describes the demand for its services as "overwhelming," with the number of operations increasing dramatically each year.

Martin praised the foundation's ultimate goal, which is to create overseas centers where local medical personnel can provide care in pediatric cardiology.

Cohen, a Gulf War veteran, was a lieutenant colonel in the U.S. Army Reserve. On Aug. 16, 2001, he died at age 47 while climbing Mt. Kilimanjaro in Tanzania, apparently of altitude sickness.