Hospitals Collaborate To Bring Specialized Cardiac Care to Children in Rural Areas

When 4-year-old Gunner Sanchez needed surgery to repair a hole in his heart’s lower pumping chamber, his family was relieved they didn’t have to travel far from their Artesia, New Mexico, home to get the highly specialized care his condition required. Instead, a surgical team from Cook Children’s Medical Center came to them, thanks to a collaboration with another Texas-based children’s hospital.

In 2018, Cook Children’s Health Care System formed a partnership with Covenant Children’s Hospital in Lubbock, Texas, to bring cardiothoracic surgical care to families living in West Texas and eastern New Mexico. The partnership is part of an initiative to make treatment more convenient for patients and families in Lubbock and the surrounding areas. Since its launch, eight children have undergone surgery at Covenant Children’s.

Gunner’s parents, Donavin and Cassie Sanchez, said staying close to home for surgery at Covenant Children’s earlier this month where they had the support of family and friends in the area was a gift to all five of their children. Gunner is a quadruplet, along with siblings Arrow, Cheyenne and Scarlett. Hazen is their 8-year-old big brother.

“Our other kids are being spoiled right now by the whole family,” Cassie said when talking about how Gunner’s siblings fared while mom and dad stayed at their son’s bedside.

Gunner, who turned four on May 3 just days after his surgery, showed no outward signs or symptoms of a heart condition. His parents describe him as a typical rambunctious and outgoing boy who loves dirt, cars and any sport with a ball.

Even so, surgery could not wait.

“If we waited until we could tell something is wrong, we’ve waited way too long,” said Vincent Tam, M.D., director of cardiac surgery at Cook Children’s Medical Center. Dr. Tam is a part of the Cook Children’s cardiothoracic team that travels quarterly to Covenant Children’s to perform surgery.

“If we were to see symptoms in a kid this age, we’re really in trouble because,” he said. “By then, the valve is really messed up, his lungs would be damaged and his heart would have been overworked.”

The hole in the lower pumping chamber, called a ventricular septal defect (VSD), makes Gunner’s heart work much less efficiently, and extra blood flow to his lungs could eventually result in damage. The defect also led to a narrowing of his aortic valve opening due to a buildup of scar tissue under the valve. As it gradually builds up over time, the scar tissue limits blood flow and can lead to a leaky aortic valve.

“If we don’t intervene, the subaortic membrane narrowing will persist, and it will actually progress over time so that months and years from now the narrowing will be even worse,” Dr. Tam explained. “It will also begin to negatively affect the function of the aortic valve. So, we don’t want things to get to the point where the aortic valve itself is in jeopardy. The extra blood flow from his VSD opening in the lower pumping chamber means more work for his heart.”

It takes a diverse team of clinical professionals from both Cook Children’s and Covenant Children’s for kids like Gunner living in more rural areas of the country to have access to this type of specialized surgical care.

“Heart surgery is teamwork, Dr. Tam said. “It’s not just me. We need a whole team of people from cardiac anesthesia to operating room staff to someone to run the heart/lung machine to ICU doctors.”

Gunner’s surgery was a success, and his parents are hopeful for his future.

“I hope he can be just like his big brother,” Gunner’s mom said. “I hope he can run and play baseball and be the healthy little boy he deserves.”

The sweetest gift of all in this unique collaboration is that Gunner was discharged from the hospital on his birthday, just in time to celebrate with his brothers and sisters.

Learn more about Cook Children's partnership with Covenant Children's here.