Lending a Hand, and a Heart, to Children Le Bonheur’s Commitment to Transplantation Is Richly Rewarded Umar Boston, MD, a pediatric cardiovascular surgeon at Le Bonheur Children’s Hospital, has done approximately 100 heart transplants on children. None of them was any more challenging than one he did almost a year ago. A baby was born with dextrocardiaheterotaxy syndrome with congenital heart block. In short, electrical activity was blocked between the upper and lower chambers of the heart. Also, the baby’s heart was malformed. In a normal heart, the apex of the heart points to the left and the major veins that go into it come from the right. In this baby, it was the opposite – the heart pointed to the right and the veins came in from the left. In addition, the function of the heart was extremely poor. This combination, Dr. Boston said, is uniformly fatal. “So we offered the mother two things,” the doctor said. “You can take your baby home and do nothing. Or we will go out on a limb and see if we can get the child to transplantation, knowing this is a very rare type of transplant that the baby would have to undergo.” The mother opted for a transplant. In surgery, the surgical team had to take a donor heart and place it in the opposite
PHOTO BY LISA BUSER COURTESY LE BONHEUR CHILDREN’S HOSPITAL
By RON COBB
Dr. Umar Boston with one of his transplant patients.
configuration than the baby’s previous heart had been in. “It’s one of the more complicated operations one can imagine or perform,” Dr. Boston said. “The child is now 10 months out from transplantation, and she’s prob-
ably done the best of any transplant that I’ve ever taken care of.” Dr. Boston is surgical director of the Heart Transplant and Mechanical Circulatory Program and surgical director of the Adult Congenital Heart Disease Program
at Le Bonheur. Two unfortunate events – a death and a hurricane -- played a big role in getting him to where he is today. Dr. Boston was born in the South American country of Guyana, and his family moved to Papua, New Guinea, when he was 5. The father, Derrick Boston, was a barrister in criminal law but was plagued by heart disease. He had his first heart attack at age 35 and died of another at age 42. What he needed was a bypass operation, but Dr. Boston said his father was reluctant to go to a doctor and believed he could rely on medication. “When you’re 11 and you see your father die of a heart attack, you question whether anything else could have been done,” Dr. Boston said. “My initial ambition to pursue medicine was certainly born out of the experience of having my father die at a very young age from cardiac disease.” Years later, after completing his cardiothoracic training at the Mayo Clinic, Dr. Boston was doing a fellowship at the University of Alberta in Edmonton when one of his mentors suggested he apply for a job at Tulane University. Dr. Boston was about to go to New Orleans for an interview when Hurricane Katrina hit. (CONTINUED ON PAGE 6)
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West TN Medical News February 2018