New parents Cassie and Michael Amick spent the better part of 2020 looking forward to the birth of their first child, a boy, due in late February. Ashton Michael Amick made his entrance into the world on Feb. 3—3 weeks before his due date.
“Besides being a little jaundiced for a day, he appeared to be a completely healthy baby,” said Cassie.
The new parents were relishing their time getting to bond with their baby when they noticed swelling around his right eye that eventually turned into a bump.
“We took him to see certified nurse practitioner Brittany Bayer, at Akron Children’s Hospital Pediatrics Mansfield, and she prescribed an ointment,” said Cassie. “When that didn’t do much, she referred us to Dr. Ian Boydstun, a pediatric ophthalmologist at Akron Children’s.”
Dr. Boydstun diagnosed Ashton with a blocked tear duct and scheduled him for a minor surgery to fix the problem on March 1.
“Ashton was only 3 ½ weeks old when he had the eye surgery, so we were a little nervous,” said Cassie. “But they were just normal concerns about him going under anesthesia, little did we know what was coming next.”
An unexpected diagnosis
Ashton’s eye surgery went well, and the family was told he would be monitored for up to 6 hours and then discharged home. But things didn’t exactly go to plan.
“The anesthesiologist noted that his oxygen levels kept dropping,” said Cassie. “They attributed it to Ashton not coming out of anesthesia well, but they decided to keep us overnight so they could continue to monitor him.”
Amanda Pelligra was the pediatric nurse practitioner covering the unit Ashton was on that evening and she noticed he was breathing funny.
“We see and care for a decent number of kids who suffer from decreased heart rate and oxygen levels as a result of anesthesia,” she said. “But in a child as young as Ashton, there are a few other things that should also be considered.”
When Amanda was handing off care to nurse practitioner Jon Baldridge they discussed getting blood pressure readings on Ashton’s upper and lower extremities if he continued to have decreased oxygen levels.
“Jon obtained the readings, and they were off, so he ordered an echocardiogram (an ultrasound of the heart) to further evaluate him for congenital heart issues,” she said.
After the 2-hour test, cardiologists Drs. Wasim Khan and Chandrakant Patel informed Cassie and Michael that Ashton had what was called a coarctation, a narrowing in the aorta that blocks blood flow to the lower body that would require surgical correction. Even more alarming was the fact that the coarctation had started to negatively affect the function of Ashton’s left ventricle.
Preparing for heart surgery
The family was immediately transferred to the pediatric intensive care unit (PICU) so Ashton could be closely monitored and start heart medications that would help open the narrowed area of his aorta in preparation for surgery.
Dr. Robert Stewart, chief of cardiothoracic surgery, said, “When the heart starts to fail due to coarctation it can progress rapidly, so it was a series of fortunate events and attention to detail by Ashton’s medical team that this was caught just in time.”
Dr. Stewart performed the surgery on March 5.
“Fortunately, Ashton’s coarctation was localized to one small area so we could repair it through the side of his chest—avoiding the need for the heart/lung machine,” he said.
Since the hospital was still taking COVID precautions, Cassie and her husband didn’t have their usual support system with them during their inpatient stay. However, Cassie says one of the PICU social workers went out of her way to make sure they were supported on surgery day.
“She put in a special request to see if our moms could be in the waiting room with us and be allowed to see him afterwards,” she said. “Luckily, the request was granted, and it meant the world to us to have that much needed support from our family.”
The 2-hour surgery went well, and Dr. Stewart says he’s hopeful Ashton won’t need more surgeries in the future.
“The vast majority of repairs last a lifetime,” he said. “The effects on blood pressure, specifically high blood pressure, will require Ashton to regularly see a pediatric cardiologist.”
The Amicks, who are residents of Mansfield, are grateful for the chain of events that eventually led them to Akron.
“From the initial referral by our nurse practitioner to the surgery with Dr. Boydstun, we were in the right place to discover Ashton’s heart defect,” said Cassie. “If we had gone somewhere else there’s a possibility this may not have been caught or caught early, and the outcome may not have been as favorable. We are very thankful.”
In 2014, Akron Children’s Hospital and the Cleveland Clinic partnered to create the Pediatric and Adult Congenital Heart Center, allowing pediatric cardiovascular surgeons and adult congenital cardiologists to collaborate on patient cases, share best practices and combine outcome data. That affiliation includes both organizations’ pediatric and adult congenital heart programs, giving families access to the very best pediatric cardiac care close to home, including surgical care for the most serious and complex congenital heart defects.