Pediatric cardiologist Donna Goff, MD, diagnosed her young patient, Marcus Volpe of Riverside, before he was born. According to Goff, Marcus had d-transposition of the great arteries, a congenital heart defect in which the heart's two main arteries carrying blood away were arising from the wrong pumping chambers.
At the time of the diagnosis, Marcus' mother was 21 weeks pregnant.
Now 1 year old, Marcus talks, plays, sleeps and cries like any healthy toddler. However, his world likely would have been different if it weren't for the care he and his mother received from Goff and the medical team at Loma Linda University Children's Hospital.
Not all babies are as lucky as Marcus. The prenatal detection rate of complex congenital heart defects in the Inland Empire is around 25%, which is lower than the national average around 50%, according to Goff. Poor early detection rates can lead to delayed treatment and worse outcomes for babies.
Erica Volpe, then 38, was referred to Loma Linda University Children's Hospital after a routine ultrasound came up abnormal. Before her son was born, he began receiving specialized care at the children's hospital known for its neonatal and cardiac intensive care units.
Erica and her husband, Rich, feel fortunate that their son's condition was detected early. "We were scared at first but we had time to establish a game plan," Erica said. "Dr. Goff explained everything to us and put us at ease as much as she could."
Because Goff was able to diagnose Marcus early, the added time allowed for regular fetal echocardiograms through Volpe's pregnancy to closely monitor Marcus. There was also time to coordinate his postnatal care with a large team including experts in maternal fetal medicine, neonatology and pediatric cardiac surgery. The team wanted to ensure a safe and successful delivery, with customized care in the neonatal intensive care unit after Marcus' birth on April 14, 2014.
Had Marcus' condition gone undetected, it's unclear if the outcome would have been the same.
At 5 days old, Marcus was strong enough to have surgery to repair his heart. The surgery was performed by cardiothoracic surgeon Leonard Bailey, MD, surgeon in chief at the children's hospital and pioneer of infant heart transplants.
Four days after the surgery, Marcus was able to go home with his family. Now 14 months old, Marcus is thriving and playing with his older brother, Michael, and sister, Bella.
"Everyone is amazed at how well he is doing," Erica said. "You would never know he has been through what he's been through."
Erica said she and her family feel lucky and are thankful Goff detected Marcus' heart defect when she did.
"Marcus is our miracle baby. We have truly been blessed," Erica said, adding that she is beyond appreciative of Goff. "She is amazing. She wants the best for these heart warriors no matter what."
Loma Linda University Children's Hospital is the leading provider of pediatric cardiology services in its four-county region of the Inland Empire.
Goff was one of six recent recipients of a community service grant from the California Chapter of the March of Dimes, titled "Improving the Prenatal Detection Rate of Complex Congenital Heart Disease in the Southern Inland Counties Regional Perinatal Program Region." The grant program provides about $750,000 combined through 2018, and $250,000 of the money will be distributed in the first year of the program while the remainder is contingent upon demonstrated program successes every year through 2018.
The money will allow Goff and her colleagues at the Loma Linda University International Heart and Perinatal Institutes to continue to improve early detection of congenital heart defects in fetuses.
Goff and her team will work to identify areas within the Inland Empire with lower rates of prenatal diagnosis of complex congenital heart defects. The data will be used to understand the barriers to prenatal diagnosis of congenital heart defects and provide outreach to improve the prenatal diagnosis rate.
"It is our mission to serve our community and work collaboratively with obstetricians, radiologists and family practice physicians in the region to improve screening for congenital heart defects," Goff said. "Dramatically improving the congenital heart defect diagnosis rate in the region will depend upon partnering with community physicians in a way that was previously unprecedented."