Jimmy Kimmel’s Newborn Son Undergoes Heart Surgery

Many saw a very different side of funny man Jimmy Kimmel last night.  He tearfully recounted the scary situation he and wife Molly McNearney recently faced after the birth of their baby on April 21st.

At three hours old, an observant nurse noticed that little William “Billy” Kimmel had a heart murmur, and also seemed “a bit purple.” An x-ray and heart ultrasound revealed that Billy had a heart condition where his pulmonary valve was closed and he had a large “hole in his heart.” He was ultimately diagnosed with a condition called Tetralogy of Fallot with pulmonary atresia. He was transferred to Childrens’ Hospital Los Angeles where he underwent a three hour surgery to open up the pulmonary valve. “He opened up the valve and the operation was a success. It was the longest three hours of my life,” said Kimmel.

Billy will need to undergo a second surgery in three to six months to repair the hole in the heart, and a a third “hopefully non-invasive procedure” when he’s in his early teens.

Billy went home a 6 days of age and is doing all the normal baby things: eating, sleeping, and peeing on mom. Jimmy showed a picture of a smiling Billy, quipping:

“Poor kid. Not only did he get a bad heart, he got my face.”

Jimmy and Molly thanked all the people who have been sending messages of support, even “old rivals”: “And I hate to even say, but even that son of a bitch Matt Damon sent flowers.”

What Are Congenital Heart Defects?

Congenital heart defects are problems with the heart’s structure that are present at birth. These defects can involve:

  • The interior walls of the heart
  • The valves inside the heart
  • The arteries and veins that carry blood to the heart or the body

Congenital heart defects change the normal flow of blood through the heart. There are many types of congenital heart defects. They range from simple defects with no symptoms to complex defects with severe, life-threatening symptoms.

Congenital heart defects are the most common type of birth defect. They affect 8 out of every 1,000 newborns. Each year, more than 35,000 babies in the United States are born with congenital heart defects.

Many of these defects are simple conditions. They need no treatment or are easily fixed.

Some babies are born with complex congenital heart defects. These defects require special medical care soon after birth. The diagnosis and treatment of complex heart defects has greatly improved over the past few decades. As a result, almost all children who have complex heart defects survive to adulthood and can live active, productive lives.

How the Heart Works

To understand congenital heart defects, it’s helpful to know how a healthy heart works. A child’s heart is a muscle about the size of his or her fist. The heart works like a pump and beats 100,000 times a day.

The heart has two sides, separated by an inner wall called the septum. The right side of the heart pumps blood to the lungs to pick up oxygen. The left side of the heart receives the oxygen-rich blood from the lungs and pumps it to the body.

The heart has four chambers and four valves and is connected to various blood vessels. Veins are blood vessels that carry blood from the body to the heart. Arteries are blood vessels that carry blood away from the heart to the body.

Heart Chambers

The heart has four chambers or “rooms.”

The atria are the two upper chambers that collect blood as it flows into the heart.
The ventricles are the two lower chambers that pump blood out of the heart to the lungs or other parts of the body.

Heart Valves

Four valves control the flow of blood from the atria to the ventricles and from the ventricles into the two large arteries connected to the heart.

The tricuspid valve is in the right side of the heart, between the right atrium and the right ventricle.
The pulmonary valve is in the right side of the heart, between the right ventricle and the entrance to the pulmonary artery. This artery carries blood from the heart to the lungs.
The mitral  valve is in the left side of the heart, between the left atrium and the left ventricle.
The aortic  valve is in the left side of the heart, between the left ventricle and the entrance to the aorta. This artery carries blood from the heart to the body.

Valves are like doors that open and close. They open to allow blood to flow through to the next chamber or to one of the arteries. Then they shut to keep blood from flowing backward.

What Is Tetralogy of Fallot?

Tetralogy of Fallot is a congenital heart defect, which is a problem with the heart’s structure that’s present at birth. This type of heart defect changes the normal flow of blood through the heart. Tetralogy of Fallot is a rare, complex heart defect that occurs in about 5 out of every 10,000 babies. It affects boys and girls equally.

Overview

Tetralogy of Fallot involves four heart defects:

  1. A large ventricular septal defect (VSD)- a hole in the part of the septum that separates the ventricles- the lower, pumping chambers of the heart. The hole allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood from the right ventricle.
  2. Pulmonary stenosis– a narrowing of the pulmonary valve and the passage through which blood flows from the right ventricle to the pulmonary artery. Normally, oxygen-poor blood from the right ventricle flows through the pulmonary valve, into the pulmonary artery, and out to the lungs to pick up oxygen. In pulmonary stenosis, the heart has to work harder than normal to pump blood, and not enough blood reaches the lungs.
  3. Right ventricular hypertrophy-the muscle of the right ventricle thickens because the heart has to pump harder than it should to move blood through the narrowed pulmonary valve.
  4. An overriding aorta-a defect in the aorta, the main artery that carries oxygen-rich blood to the body. In a healthy heart, the aorta is attached to the left ventricle. This allows only oxygen-rich blood to flow to the body. In Tetralogy of Fallot, the aorta is between the left and right ventricles, directly over the VSD. As a result, oxygen-poor blood from the right ventricle flows directly into the aorta instead of into the pulmonary artery to the lungs.

Together, these four defects mean that not enough blood is able to reach the lungs to get oxygen, and oxygen-poor blood flows out to the body.

Babies and children who have tetralogy of Fallot have episodes of cyanosis, a bluish tint to the skin, lips, and fingernails. Cyanosis occurs because the oxygen level in the blood is below normal.

How is Tetralogy of Fallot treated?

Tetralogy of Fallot must be repaired with open-heart surgery, either soon after birth or later in infancy. The timing of the surgery depends on how severely the pulmonary valve is narrowed.

Surgery to repair Tetralogy of Fallot is done to improve blood flow to the lungs and to make sure that oxygen-rich and oxygen-poor blood flows to the right places. The surgeon will:

  • Widen the narrowed pulmonary blood vessels. The pulmonary valve is widened or replaced, and the passage from the right ventricle to the pulmonary artery is enlarged. These procedures improve blood flow to the lungs. This allows the blood to get enough oxygen to meet the body’s needs.
  • Close the ventricular septal defect (VSD). A patch is used to cover the hole in the septum. This patch stops oxygen-rich and oxygen-poor blood from mixing between the ventricles.

Fixing these two defects resolves problems caused by the other two defects. When the right ventricle no longer has to work so hard to pump blood to the lungs, it will return to a normal thickness. Fixing the VSD means that only oxygen-rich blood will flow out of the left ventricle into the aorta.

Over the past few decades, the diagnosis and treatment of Tetralogy of Fallot have greatly improved. As a result, most children who have this heart defect survive to adulthood.

(Source: NHLBI)

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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