Wyatt Miller has a bright future, thanks to lifesaving heart care from Akron Children’s.
Wyatt Miller of Newcomerstown was a rambunctious toddler. There were no signs of a serious, congenital heart defect that would change his life forever.
At a checkup when he was 20 months old, Wyatt’s doctor detected a heart murmur. A week later, Wyatt returned to the doctor’s office because of an ear infection, and a different primary care provider noticed the murmur. “The second doctor said if Wyatt were his grandson, he’d take him to Akron Children’s,” Wyatt’s mom, Sara Thomas, said.
Diagnosis and surgeries
Wyatt had his first appointment with Dr. Brandon Smith, cardiologist in the Akron Children’s Heart, in May 2020. Wyatt received an echocardiogram, which is an ultrasound that evaluates heart structure and function. The diagnosis: severe subaortic stenosis. “This condition is narrowing of the outflow from the left ventricle – the left pumping chamber – to the body,” Dr. Smith shared. “The cardiology team reviewed Wyatt’s case the same week of his diagnosis, and he underwent open-heart surgery about a month later.”
Wyatt was born with a relatively small aortic valve, plus tissue underneath the valve that caused considerable blockage. “Even though he was only 20 months old, we felt we needed to go in and try to cut out the tissue below the valve,” said Dr. Robert Stewart, cardiovascular surgeon and chief of cardiothoracic surgery. “We carefully removed that ridge of tissue, and the results were spectacular. The amount of blockage went from ‘moderate to severe’ to trivial. Wyatt’s aortic valve at that point was still pretty good.”
A toddler needing open-heart surgery is scary, but Sara and her family knew it was best for Wyatt. “Everything happened so fast – from diagnosis to surgery – but everything went super well,” Sara shared. “Wyatt had surgery on a Tuesday and went home two days later.”
Wyatt as a toddler, a small but mighty heart warrior.
Dr. Smith kept a close eye on Wyatt, and the blockage problem returned. Wyatt had a second open-heart surgery at age 4 1/2. “We could see there was still tissue below the valve – and the valve wasn’t growing proportionally to Wyatt,” Dr. Stewart said. “We went back in and removed as much tissue as we safely could below the valve. We didn’t want to replace the valve at that point because Wyatt was still pretty little. We hoped the valve would grow.”
Wyatt needs a third surgery
Wyatt recovered from his second surgery, but at age 6, began showing signs of fatigue, breathlessness and a racing heartbeat. “With these symptoms, we knew we had to do something about the valve,” Dr. Stewart said.
Wyatt had his third surgery on New Year’s Eve of 2024. For Wyatt’s age, the best option was to replace his aortic valve with his own pulmonary valve – and then replace the pulmonary valve with a donor one. “We had to cut into the heart a little bit, where the blood comes out, to make the angle bigger to fit the larger pulmonary valve,” Dr. Stewart explained. “The fancy name of this operation is a Ross-Konno procedure; Dr. Tara Karamlou and I have done a number of these.”
Dr. Karamlou, a pediatric cardiac surgeon at Akron Children’s who was involved in Wyatt’s surgeries, calls the surgical team “well-choreographed” and credits them with the success of Wyatt’s three open-heart surgeries. “Everyone knows their role and how to execute it,” she said. “But the team stays attuned to everyone’s roles to maximize efficiency and cross-training. In essence, this approach is a way to keep the entire team in sync with one another, which is really important.”
Performing the Ross-Konno procedure earlier would’ve been much riskier for Wyatt. “Our team choreographed this sequence of operations to provide Wyatt with the lowest surgical risk of complications and to maximize the durability of the Ross operation,” Dr. Karamlou explained. “We kept our eyes on the long game of his aortic valve disease. If we had done the Ross-Konno operation earlier, there is a potential for future valve procedures and conduit replacements. We wanted to safely get him to the spot where he can get an operation to replace his right-ventricle to pulmonary artery conduit as an adult, which could be done through a catheter in his groin instead of open-heart surgery.”
Wyatt is strong – and so is his family.
Wyatt today
Wyatt’s chest bone is healing well, and he’s back to seeing Dr. Smith for regular checkups. “He’ll require continued cardiology follow-up with me through early adulthood – and then he’ll transition to adult cardiology care,” Dr. Smith said. “It is great to follow patients like Wyatt long-term, as you get to see them grow from toddlers to school-age children to adolescents and beyond.”
Wyatt likes to play video games, and he’s joined a local T-ball team. “From 20 months old to 6 years old, it’s been a lot. But without the Akron Children’s cardiology team, I don’t think Wyatt would still be here,” Sara said. “He can tell you so much about his surgeries, and he sounds so grown up. He’s the strongest kid ever.”
Learn more about the Akron Children’s Heart Center.
