Triumphant Start for Tiny Heart Warrior, Thanks to Pediatric Cardiac Team

Pediatric Heart Patient Christopher McNall

Albany Medical Center’s Congenital Heart Program has long been known as a standout in New York State for patients with congenital heart disease (heart defects that are present at birth). Led by Neil Devejian, MD, one of the most experienced pediatric cardiothoracic surgeons in the nation, the program recently welcomed pediatric cardiac intensivist Adnan Bakar, MD, ’05, who was recruited to head up the Division of Pediatric Cardiac Intensive Care, and fellowship-trained pediatric interventional cardiologist Jess Randall, MD.

The McNall family, of Wynantskill, was certainly grateful for this strong reserve of specialists when their lives turned upside down last fall.

Katelyn McNall, an elementary special education teaching assistant, was pregnant with their second son, Christopher, and things had been going beautifully until an echocardiogram, administered at the end of her third trimester, revealed that he had a condition called tetralogy of Fallot—a combination of four congenital heart defects.

“Suddenly, we were told we were going to need a whole team of doctors,” McNall said. Albany Medical Center’s Maternal Fetal Medicine coordinators worked briskly to set up a meeting for McNall and her husband, Bryan. “The plan was to meet our team right away, so we could better understand what was happening. Then I went into labor. Everything happened so fast.”

This didn’t mean, however, that the heart team wasn’t on the job. “My first in-person conversation with Dr. Randall was in the delivery room,” McNall said. “He came in to let us know that they were tracking Christopher’s case very closely.”

And he stayed until after Christopher was born.

“He was just great,” McNall said. “He came back and explained everything to us. He drew us pictures. I’m a teacher, so I love a visual. We felt a lot of relief. We knew what was ahead of us, and we felt reassured.” They were additionally heartened, she said, knowing they didn’t have to travel to a larger city to receive the highest level of care for their son. “One of the nation’s best pediatric cardiac programs was right here in Albany!”

After the McNalls took Christopher home, Dr. Randall saw him for office visits and kept a continual check on his oxygen saturation levels. Because of the structure of his heart, the blood it pumped out to the rest of his body was oxygen-poor.

Tetralogy of Fallot is characterized by a large hole between the left and right ventricles (the heart’s main pumping chambers). Another component of the defect is a narrowing at or beneath the pulmonary valve, which controls the flow of blood to the lungs. Surgery is the only effective treatment for tetralogy of Fallot. The long-term prognosis is excellent, though patients do require regular cardiac follow-up for the rest of their lives.

Because of the complexity of Christopher’s case, including some risk factors like underdeveloped lung arteries, Dr. Devejian determined that a preliminary shunt procedure would be the best first step.

“We trusted him,” McNall said. “We knew we were in good hands.”

For more than two decades, Dr. Devejian has cared for infants, children and adults with congenital heart defects. He has been ranked among the top surgeons in New York State, based on rates related to his surgical outcomes, and he credits the strength of the team around him for the program’s success: pediatric specialists in cardiology, anesthesia, radiology and respiratory therapy; intensivists, hospitalists, OR techs, nurses, perfusionists and child life specialists.

At six weeks old, Christopher came through the shunt procedure very well. He recovered in the Pediatric Intensive Care Unit, where Dr. Bakar kept a close watch over him. “We have a special nursing staff for our heart patients in the PICU,” Dr. Bakar explained. “It’s kind of like a unit within a unit.”

“It’s an amazing team,” McNall said. “The doctors and caregivers just don’t leave those bay windows. You feel like there are always eyes on your little one. It brings you a lot of comfort.

Christopher left the Pediatric Intensive Care Unit on a triumphant note, wearing a onesie that said “Peace Out, PICU.” His parents are showering him with love and care so he is strong for his next surgery—a repair that will close a hole between the lower chambers of his heart and open up restricted blood flow to his lungs—and they’re inspired by his progress.

“He recently had an evaluation for development and behavior,” his mom said, “and there are no delays for his age. In fact, he’s above average for his age range. We are so proud of our brave little heart—and the phenomenal team who’s looking out for him.”