By only six weeks’ gestation, the heart chambers of an embryo are already taking shape, with the ventricular septum – the muscular wall between the lower left and right heart chambers- complete. If any portion of the ventricular septum does not form correctly or if any components do not appropriately grow together, it is called a ventricular septal defect, or VSD. While genetics and environmental factors probably play a role, there is often no clear cause for this congenital heart defect. Such was the case for Keyla Flores, born in early 2013. Keyla has a particularly complex type of VSD commonly known as “Swiss cheese,” in which multiple muscular (or trabecular) VSDs occur, producing a very large communication between the ventricles.
When Keyla arrived, her parents Edwin and Yola were already struggling. They had moved their family several times in recent years in search of employment and better living conditions, in particular a favorable climate for their oldest daughter, Abigail, who suffered asthma. After Keyla’s birth, Yola had little time to dedicate to Abigail or the two middle children. The baby struggled to breathe and turned blue when she tried to eat and when she cried, and she was almost always sick, with repeated high fevers. Her condition worsened as the months went on. The family was referred to Clínica Belga in Cochabamba, Bolivia, for consultation with the pediatric cardiologist, Dr. Navarro. Standard protocol for cases such as Keyla’s calls for surgical closure of the VSD within the first year of life to prevent development of irreversible pulmonary obstructive disease (i.e. Eisenmenger syndrome).
Before Keyla could even go into surgery, she would require hospitalization to stabilize her condition. After surgery, she might be in the intensive care for weeks. And her condition might require repeat interventions. It would have been an overwhelming scenario for any family, but Edwin and Yola found themselves particularly challenged. The Flores family gets by on an unsteady income of around $300-$350 dollars a month brought in by their small business selling sausage sandwiches. Nevertheless, they were determined to find the help they needed to save their daughter. Fortunately, they were referred to Solidarity Bridge’s heart program locally managed in Cochabamba by Puente de Solidaridad (PuenteSol). The surgeon, Dr. Carlos Brockmann, had to make sure all the conditions were optimal for Keyla’s intervention. The operation was postponed several times due to fevers and other concerns, but on July 24, 2013, Keyla received her surgery at Clínica Belga. She continues to be closely monitored by the Belga team, while they determine the next steps for her treatment. The doctors, Keyla’s family, and the entire Solidarity Bridge/PuenteSol team is hopeful for a beautiful future for Keyla. This surgery was made possible through the financial support of Dharma Trading Company.