After complex heart surgery, Yah’ir is all smiles

Christina Moreland and Jimmy Austin want their 6-month-old son, Yah’ir, to have a bright future, one where he can pursue all of his dreams. “He can do whatever he wants to do,” Christina says.

There’s just one caveat, an understandable one considering that Yah’ir is recovering from complex heart surgery. “As long as he doesn’t go bungee jumping when he’s older,” Christina adds, half-joking, half-serious. “I wish I could keep him in a bubble.”

Finding support before Yah’ir’s birth

Like her daughter Surai’s birth, Christina planned to deliver Yah’ir at Brigham and Women’s Hospital, and visited their offices for her prenatal appointments. At her six-month checkup, an ultrasound revealed an issue with her placenta. Through Brigham and Women’s affiliation with Boston Children’s, she was able to be seen at the Maternal Fetal Care Center (MFCC), which brings together specialists from the hospitals’ many medical disciplines to proactively screen and care for mothers carrying fetuses with life-threatening congenital defects.

A fetal echocardiogram at the MFCC showed Yah’ir had an atrioventricular (AV) canal defect with severe leakage from his heart’s valves. That occurs when a combination of related heart conditions creates a large defect in the center of the heart. When left untreated, an AV canal defect can cause serious heart and lung problems and significantly harm a child’s development.

Clinicians from both hospitals worked together to prepare for Yah’ir’s birth at Brigham and Women’s and his eventual transfer to Boston Children’s. A team consisting of cardiac surgeons, cardiologists, maternal-fetal medicine specialists, nurses, and other clinicians met often to plan how they could best support Christina throughout her delivery and then be ready to immediately care for Yah’ir. 

Christina and Jimmy, meanwhile, appreciated how Dr. Aditya (AK) Kaza, a cardiac surgeon at the Benderson Family Heart Center, and Dr. Wayne Tworetzky, director of the Fetal Cardiology Program, explained in relatable terms how they would treat Yah’ir’s AV canal. They also valued the care provided by MFCC nurse Lauren Farqui and Dr. Sarah Little, a Brigham and Women’s maternal-fetal medicine specialist.

An anxious wait for heart surgery

Despite all the preparation, Christina and Jimmy still couldn’t help but feel a wide range of emotions after Yah’ir’s birth in August. “I knew it was a sensitive situation, but I didn’t take in the severity of it until I had him,” she recalls. 

Yah’ir couldn’t immediately have surgery because his heart valves were not yet strong enough for an operation. Even though his parents were anxious waiting, they also understood surgery couldn’t be rushed. It helped that throughout Yah’ir’s wait in the Cardiac Intensive Care Unit (CICU), MFCC staff continued to support the family. For instance, Christina and Jimmy often sought advice and received updates from Farqui, a familiar face who had been by the family’s side for months and knew the details behind their journey. She also often visited Yah’ir to see firsthand how he was faring. The wait ended a month later, when Dr. Kaza repaired the AV canal defect and the leaking atrioventricular valves.

Yah’ir recovered for two months in the CICU, where the team trained Christina and Jimmy to deliver medications and nutrition through a feeding tube, a common step for infants with congenital heart defects. Despite Yah’ir’s long stay, they felt he had a caring home at Boston Children’s before he finally got to see his own home in a Boston suburb a day before Thanksgiving.

Enjoying family life and short naps

Yah’ir smiles a lot. The only time he doesn’t smile is when he cries for food or when he’s tired. The briefest of catnaps will end his fatigue. “He’ll be tired and fall asleep for no more than five minutes,” Christina says. “Then he’ll wake up and that’s it.” After staying awake most of the day, he sleeps soundly throughout the night.

When he’s awake, he enjoys watching cartoons along with Surai. He loves the attention his 4-year-old sibling gives him. “She calls him ‘my baby,’” Christina says. Yah’ir occasionally has follow-up exams at Boston Children’s, where his care team says he’s healthier and stronger. He soon might be able to eat without a feeding tube. 

Looking back, Christina says the month between Yah’ir’s birth and surgery was an emotional roller coaster. She and Jimmy balanced caring for Surai at home while visiting Yah’ir every day in the CICU, often wondering when he would be strong enough to undergo surgery. “It was intense, but we had to stay strong,” she says. 

Yah’ir’s future looks brighter and safer now that he likely won’t need more surgery, only follow-up care from his doctors and support from his family. All along, Christina and Jimmy had faith that Yah’ir would get there. She adds, “I knew he was in good hands because it was Boston Children’s.”

Learn more about the Neonatal Cardiac Surgery program and fetal care at the MFCC, or make an appointment.