January - March 2013 Edition: Naples Health

The transposition means oxygen-poor blood is circulating through the right side of the heart and back to the body without passing through the lungs. At the same time, oxygen-rich blood from the lungs is returning to them without reaching the brain and the rest of the body. Dr. Onal explains that fetal circulation is different as there is a communication via patent ductus arteriosus (PDA) and patent foramen ovale (PFO) between the two sides of the heart that allows mixing of the oxygenated and non-oxygenated blood. That’s why Caden’s condition wasn’t immediately noticeable and why he was able to score well on the Apgar. “The PDA closes normally within the first 30 minutes to 48 hours of life,” Dr. Onal says. “If not diagnosed and treated promptly, this congenital heart disease is usually fatal. Once the infant is in shock, it’s really difficult to turn things around.” glandin, a medication that relaxes the muscle in the arterial wall and helps to keep the PDA open. But he knew the PDA wasn’t allowing enough mixing of the blood and that the infant needed an atrial septostomy, a cardiac catheteriza- tion to enlarge the opening between the atria (PFO) using a special balloon. And that meant airlifting the infant to Miami Children’s Hospital, where pediatric cardiac surgery is available. Catheterization was only the first step. The baby would also need an arterial switch operation. The catheterization would allow time for Caden to grow a bit stronger before that intense surgery to switch the arteries in his heart. As it turned out, that was not to be. “They hoped to take the oxygen tube out so that Caden could nurse,” Erin, his mother, says. “But every time they tried to wean him off the ventilator, his heart didn’t handle it well.” After four days, surgeon Redmond Burke, M.D., decided they couldn’t wait any longer. During the surgery, the surgical team FAST ACTION AND AN AIRLIFT Dr. Onal started Caden on prosta-

SWICFT Cardiology | SWICFT Health | Southwest Florida Research Clinical Excellence Driving Personalized Cardiovascular Care

The Southwest Institute for Cardiovascular Fitness & Treatment

James V. Talano, MD, MM, FACC Peter R. Foster, MD, FACC Sajan K. Rao, MD, FACC Healthcare is changing. In an era when physicians face increasing pressure to see more patients with shorter visits, our group remains steadfast to the principle of taking the time to understand the total patient and their needs. We are also committed to maintaining an active relationship with our patients to optimize health and wellness. The SWICFT Institute was established to promote cardiovascular health and wellness through the delivery of the highest quality cardiovascular care, the latest cardiovascular diagnostic testing and treatments, and the most current preventative measures including lifestyle, diet, exercise and nutrition management. SWICFT Cardiology

Shannon M. Brown, ARNP Janet K. Sparker, PA-C, RN

239.261.2000 ph. 239.261.2266 fax

625 9th Street N., Suite 201, Naples, FL 34102 973 North Collier Blvd., Marco Island, FL 34145



Naples Health | JANUARY-MARCH 2013

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