The Montreal Children's Hospital of the McGill University Health Centre is very happy to announce that Laeticia Lagueux has been discharged and is doing very well after receiving a new heart on September 13, when she was only three weeks old. Laeticia is the youngest child in Quebec to receive a heart transplant. Since her surgery, she has gained weight and is interacting with her parents, the nurses and the doctors.
Laeticia was born during the afternoon of August 20. She immediately began to have difficulty breathing and her heart was beating very quickly. She was intubated and transferred within 24 hours to the Children's Intensive Care Unit (ICU), where she was placed on ventilatory support and her medical team began to look for the cause of her medical problems.
The newborn was diagnosed with congenital cardiomyopathy; basically, she had an enlarged heart and the heart muscle was functioning poorly. Her heart was structurally normal, but the muscle of the heart was too weak and could not pump adequately.
Laeticia's condition continued to deteriorate. On September 3, her name was placed on the North American organ donation list and the wait began for a new heart. On September 13, a heart became available and Drs. Renzo Cecere and Christo Tchervenkov successfully performed the heart transplant operation.
"Laeticia is very fortunate to have received a heart so quickly," said Dr. Tchervenkov, Director of Pediatric Cardiovascular Surgery, the Montreal Children's Hospital, and Professor of Surgery, McGill University. "After the surgery, her condition improved quickly and she was extubated within five days, which is amazing."
Dr. Cecere, cardiac surgeon and Surgical Director of Adult and Pediatric Heart Transplantation and of the Mechanical Heart Program, points out that infants under the age of three months tolerate transplants, especially heart and liver transplants, better than older infants and children because their immune system is not fully developed, making their bodies more able to accept the new organ.
It is imperative that Laeticia remain infection free for at least six months because her immune system is suppressed and an infection could provoke her body to reject her new heart. There will be a risk of rejection for one to two years. Currently she is taking four different medications, but this will eventually be reduced to two medications per day.
"Laeticia's care down the road will be very simple. Within a year, she should be like any other little girl, and developmentally should have caught up with her peers and will be able to attend daycare and school," said Dr. Geoffrey Dougherty, Division Head of Intensive Ambulatory Care Service and Associate Pediatrician-in-Chief.
The Intensive Ambulatory Care Service of the Children's will follow Laeticia until she is 18 years old and transferred to our adult hospital. The highly specialized team in this department treats children with very challenging conditions on an out-patient basis. Laeticia will likely have an appointment every three months.
Down the road
Looking down the road, it is difficult to predict how long Laeticia's new heart will last. There are children who had heart transplants 17-18 years ago. "We just don't know. The field of heart transplantation has changed very quickly. In the last five years, a variety of better anti-rejection medications have come on the market. We presume our patients will do better, we just don't know how much better," said Dr. Dougherty.