Nathaniel Daly, now nearly three years old, and his mom, Jennifer (foreground), have a follow-up visit with pediatric cardiologist Dr. Achiau Ludomirsky.
Photo: Karsten Moran
Jennifer Daly was nearly full-term when diagnostic scans revealed that her unborn baby had an underdeveloped right ventricle, the heart chamber that pumps blood to the lungs for oxygenation. He was able to thrive within the womb, where the mother oxygenates the fetus’s blood, but to survive on his own, he would need a series of three risky open-heart surgeries staged over the first two years of life. Doctors at another hospital suggested that it might be more merciful to let nature take its course, resulting in death within days of birth. But Achiau Ludomirsky, MD, the Andrall E. Pearson Professor of Pediatric Cardiology and director of the Division of Pediatric Cardiology at NYU Langone, saw nothing but hope. Having successfully treated many similar cases by teaming up with a cardiac surgeon, he was certain that this newborn could be saved.
Trusting her maternal instincts, Daly, 24, embraced Dr. Ludomirsky’s confidence and optimism, and arranged to have her delivery at NYU Langone’s Tisch Hospital. But two weeks before her mid-November 2012 due date, Hurricane Sandy bore down on New York City, forcing the indefinite closure of Tisch Hospital. Daly was referred to another local hospital that could safely usher her newborn into the world and perform the first lifesaving operation, implanting a temporary artificial shunt that would send blood to his lungs. The operation was a success, and baby Nathaniel was sent home nine days later.
Trusting her maternal instincts, Jennifer Daly embraced Dr. Ludomirsky’s confidence and optimism, and arranged to have her delivery at NYU Langone’s Tisch Hospital.
Daly brought her son back to NYU Langone for the next two surgeries, in which the heart’s major vessels would be rerouted so that the single healthy ventricle could do the job of two. “You can’t do a complete correction all at once,” explains Dr. Ludomirsky. “The pulmonary arteries and lungs need time to adapt to the new, increased blood flow.”
Such repairs are highly complex, but Dr. Ludomirsky was confident that that challenge could be met by his colleague in the Department of Cardiothoracic Surgery, Ralph Mosca, MD, the George E. Reed Professor of Cardiac Surgery and director of the Division of Pediatric and Adult Congenital Cardiac Surgery. “With his exceptional skills, I knew when I first met him that he would become one of the world’s top pediatric cardiac surgeons,” says Dr. Ludomirsky, who has worked with Dr. Mosca on and off since 1992, including the last seven years at NYU Langone. Over that time, they’ve become an impressive team, handling hundreds of complex pediatric cardiac cases annually with a success rate second to none. In fact, every child they’ve treated together over the last year has survived. “We’re two completely different personalities, but between us, there’s total trust,” says Dr. Ludomirsky. “If he’s confident in a clinical decision, there’s no second-guessing it. That trust works both ways.”
Dr. Achiau Ludomirsky with Nathaniel Daly.
Photo: Karsten Moran
Dr. Ralph Mosca with Jennifer and Nathaniel Daly.
Photo: Karsten Moran
Daly was understandably anxious about what lay ahead, especially when Nathaniel needed an emergency operation to clear scar tissue from his pulmonary artery. With that complication out of the way, Dr. Mosca could start the repairs. “Fortunately, my family was very supportive,” says Daly, “and Dr. Mosca was so calming and so positive.”
Several months after his final operation, Nathaniel, now almost three, is thriving. “He was pretty active before his last surgery, but he didn’t have the breath to match what he wanted to do,” recalls his mom. “Now, his energy level is crazy. It’s a nice problem to have.”
“Is he going to be an Olympic athlete?” says Dr. Ludomirsky. “Absolutely not. But he can play recreational sports and have a completely normal life.”
Today, Jennifer Daly’s days are largely consumed by parenting, but she also finds time to serve as a member of the Family Advisory Council and as a parent counselor for the Sala Institute for Child and Family Centered Care within NYU Langone’s Hassenfeld Children’s Hospital. “When I was pregnant, I connected on Facebook with a parent who had been through an experience like mine. It had a huge impact on me,” says Daly. “Now, I’m giving back.”
