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Full Hearts Over Amazing Recovery of Tiny Medical Marvel Isaac Tymchuk

Written by Keith Gerein

To see Isaac Tymchuk run, climb and grin mischievously at his parents, you’d never guess the blond toddler has spent much of his young life in operating rooms and hospital beds.

The tiny Calgarian’s playground prospects were very much in doubt after being born in 2014 with a number of serious heart defects. But thanks to two remarkable surgeries at the Mazankowski Alberta Heart Institute, Isaac now has enough energy to keep his parents constantly on the run.

“He loves cars and trucks and trains. And climbing anything he can. He will try to climb every piece of furniture, and every piece of playground equipment,” Shandra Tymchuk said Monday, watching her son scale the decorative pools in the Mazankowski’s healing garden.

“He was slow to walk, slow to talk, slow to pull himself up, so he now is catching up with all of these regular toddler milestones and it’s pretty unreal to watch.”

Isaac was actually still in the womb when an ultrasound revealed at least one heart abnormality, a severe narrowing of his aortic valve that was inhibiting the growth of the left ventricle.

Shandra travelled to Toronto in June 2014 for a rare in-utero procedure, in which a balloon was inserted into the fetus’s valve to increase his chances of survival.

A few months later, just 16 days after his birth in Edmonton, Isaac made history as the first baby in western Canada to receive a two-part heart operation at the Mazankowski’s new cardiac “hybrid” operating room.

Posted on September 20, 2016, The Edmonton Journal
The facility allows cardiac surgeons and cardiologists to work on the same patient at the same time. In Isaac’s case, while a surgeon inserted bands to better regulate blood flow to the baby’s lungs, a pediatric cardiologist inserted a stent into a small artery to give the heart another route to circulate blood.

Those simultaneous procedures were designed to give Isaac’s heart time to grow and function better, preparing him for an even more difficult surgery five months later.

That operation, performed by Dr. Mohammed Al Aklabi, was a high-risk, six-hour marathon that repaired four heart defects.

“I don’t think there is name for that type of surgery because of the combination of repairs that were done,” Shandra said. “It was stressful and scary but at the same there was a calmness with the confidence level we had in this centre and the surgeon.”

The boy’s aortic valve was removed and replaced with his own pulmonary valve, which was itself replaced with a conduit made from a cow’s jugular vein.

Isaac’s aortic arch was then doubled in size from four millimetres to eight, his mitral valve was replaced with a mechanical valve, and a hole in his heart was surgically closed.

“We had to reconstruct almost the whole heart,” Al Aklabi said. “I was confident but we also know our limits. He was very small and when we look at the literature there is a high risk of mortality.”

Though the worst appears to be over, Isaac will be on blood thinners the rest of his life and will require at least one more surgery once he outgrows the mechanical valve. A heart transplant is also a possibility in the future, though Al Aklabi said he hopes that can be avoided.

“It’s very gratifying to all of us to see him thriving with his family,” he said.

Shandra Tymchuk presented Al Aklabi with a token of her appreciation Friday: the medal she earned running in the Calgary marathon earlier this year.

“I actually broke my hip during the run,” she told the surgeon. “I still had 3.5 kilometres to go. I thought about Isaac and I thought about you and I knew I had to finish the race.”

The hybrid operating room, which was built with $6.6 million in funding from the University Hospital Foundation, has hosted 167 procedures since opening in 2014.

Posted on: September 20, 2016 by The Edmonton Journal