Cardiology

DIFFICULT DECISIONS The National Children's Heart Centre in Our Lady's Hospital, Crumlin, sees in the region of ten thousand children as outpatients, and operates on about five hundred of these children annually. One in every one hundred babies born in Ireland is born with a congenital heart defect, and all come to Crumlin to be operated on, some within hours of being born. Recent advances in heart surgery has meant that children with complex heart conditions who previously wouldn't survive now have a chance at life. However, often in these cases, surgical interventions are palliative and can only buy time in the hope that future developments will unlock new options to prolong their lives in fifteen or twenty years time. Baby Zack Murphy is one of these children. Diagnosed antenatally with hypoplastic left heart, dextrocardia and situs inversus - his heart is located on the right side rather than the left, and all of his organs are the wrong way round - mother Aoife was offered the option of a termination, or withdrawing medication and palliative care after birth. However, after a meeting with Professor Mark Redmond who offered high risk surgery and a possibility of success, Aoife decided to give her baby the option of survival. The first procedure was a palliative treatment to buy time to enable Zack to put on enough weight to survive more extensive heart surgery. During the course of the documentary, we follow as the team embark on the next incredibly novel stage of surgery. While Professor Redmond has performed aspects of it before, this is the very first time to attempt all of these elements in the one surgery. Three year old Lee Cotter from Cork was diagnosed antenatally with an extremely rare heart defect and was his mother Aisling was told that the pregnancy probably wouldn't culmintate in a live birth. Fighting all odds, Lee was born at 9 months despite numerous heart abnormalitles; transposition of the great arteries, two holes in his heart, and again, his heart was positioned on the right side of his body rather than the left. We follow as Lee embarks on his third open heart surgery; the 'Double Switch', the 'complex end of complex' when it comes to surgeries carried out in Crumlin. There are very few statastics on outcomes as it is carried out so rarely. As well as these highly complex surgeries, the doctors also carry out curative full repairs, such as the operation faced by five month old Clara Cleary from Donegal. Clara is a Down Syndrome baby with AVSD (atrioventricular septal defect). 22% of babies operated on in Crumlin's Cardiology Department have Down's Syndrome, something unique to Ireland, due to women proceeding to full term with their pregnancies. Also featured is thirteen year old Glen Carey from Limerick. Glen was recently diagnosed with a fatal abnormal heart rhythm, and we follow as Consultant Paediatric Cardiologist Paul Oslizlok fits an ICD device to regulate his heart.