Five Pound Fighter

This is a story about a Valentine's Day gift that Kaitlyn and Eric Baker received but didn't know if they'd be able to keep. It was a baby, but he was no ordinary baby. Mom knew that midway through her pregnancy, when she went in for a routine echocardiogram.

James Baker's heart had several major defects. Among them was a missing coronary artery, which supplies the heart with blood. Just days after James was born, it became clear that the only way for him to survive would be a heart transplant. But one early morning a few days later, James began to struggle to breathe. Enter Cincinnati Children's heart surgeon Dr. David Morales.

"Unfortunately, when you don't have a right coronary, sometimes the heart starts to become ischemic. Basically he started having heart attacks," said Morales.

"And they said he's not going to make it to transplant unless we do something," said James' mom.

Doctors implanted a ventricular assist device, or VAD, which was used to pump blood from his single ventricle to the rest of his body. The problem was, the team at Cincinnati Children's wasn't aware of any child as small as James – just five pounds – successfully being transplanted after being on a VAD.

"We had to create a shunt to get blood to his lungs, and then we put him on this ventricular assist device. And this allowed us to close his chest, take his breathing tube out, and have him start eating while he waited," said Morales.

The VAD did what older devices couldn't do. It allowed James to get stronger while he waited for a new heart. A month after James got his VAD, the Bakers got another holiday gift – a new heart for James. This time it arrived on Easter.

"And I got the phone call. And it was amazing because we were still in the ICU. All these nurses and people right outside the door were like 'is this this phone call?' They were excited and I was like yes!" said James' mom.

"It's an absolutely remarkable accomplishment, both medically and by this little guy here," said James' dad.

According to Dr. Morales, James is likely the smallest child ever to get a VAD, make it to transplant, and then get discharged to home.

"He got to transplant without a breathing tube, all his end organs working well and eating. That's a very different way to get to transplant. And his future with his transplant should be great. He should have that transplant for decades," said Morales.

Patients such as James Baker give hope to everyone at Cincinnati Children's that the days of having nothing to offer such complex patients are growing shorter. The Bakers also have hope – for a bright future for their young son.

(Published April 2022)