ANDREW SAWYER

April 20, 1985 - Pulmonary Atresia

I was born on this day with a congenital heart condition known as pulmonary atresia. The moment I came off the oxygen from my mom's uterus, my body became a blueish-gray color. Known also as ‘blue baby syndrome,’ my pulmonary valve did not develop. It was like a gate closed shut, stopping all oxygen from moving to my lungs. A hole in the upper chambers called atrial septum defect (or ASD), allowed the blood to mix which allowed blood flow and some low levels of oxygen. There are numerous congenital heart defects. Pulmonary atresia is similar to a more common condition called Tetrology of Fallot, which is a complex defect requiring surgery to fix. At one-day-old, I was flown on a helicopter to Egleston Hospital in Atlanta where I would have my first of three operations in 36 hours.

May 3, 1985 - Operations # 1 - 3

After diagnosis by pediatric cardiologist, Dr. Jane Todd, I was moved to surgery. Since a baby's heart is only the size of a walnut, no homograph type heart valve would fit this size. The procedure to use a shunt was developed in 1944 by Dr. Alfred Blalock, Dr. Vivien Thomas, and Dr. Helen Tausigg (BTT Shunt) to move blood from the subclavian artery to the pulonary artery. This palliated the condition allowing a short-term fix.

At Egleston Children's Hospital, Dr. Willis H. Williams conducted this operation when I was 13 days old. As with many heart operations, Dr. Williams endured complications. The first shunt he inserted clotted. He operated a second time with a shunt from a different manufacturer. After this operation, this shunt also clotted and failed. My grandmother, Juanita Sawyer, told me that Dr. Williams called in his emergency surgery crew to operate a third time. He used a larger shunt which would be for a 3-month-old baby. My dad remembers when the very exhausted Dr. Williams greeted them in the waiting room. His words were very calm:

“That's the largest shunt I have every put in a baby. If this one doesn't work, there's nothing else we can do.”

March ?, 1986 - Operation #4

In the 1960s, a more corrective repair was developed by a New York heart surgeon named Dr. Jim Malm. But the 60s and 70s would still be wrought with high surgical mortality, especially from lack of post-operative care. Many congenital heart defects restricted the right side of the heart. The BTT shunt buys time for a repair called RIGHT VENTRICULAR-OUTFLOW TRACT RECONSTRUCTION. In this surgery, the conduit of the pulmonary artery was cut open and a patch placed across the top. There was still no heart valve, but blood could flow through this conduit to my lungs.

The operation was a major success, but unfortunately, myself and an eight-year-old girl suffered staph infection inside the incision. Dr. Williams once again went to work. He cut the incision down to my waste and removed the entire ab muscles on my right side. He placed the muscles under the incision to draw blood to the infection.