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A Family Works to Safeguard the Transition to Adult Cardiac Care

December 01, 2009

Joel Brenner, M.D., with Bryce, Brett and Tara Warthen in summer 2009.

Hopkins Children's cardiologist Joel Brenner has known Bryce Warthen since he was only hours old and blue. Born with transposition of the arteries, Bryce would undergo his first cardiac surgery at Hopkins just hours later.

With transposition of the arteries, the two major arteries leaving the heart connect to the wrong ventricles or lower chambers of the heart. As a result, the blood oxygenated by Bryce's lungs was being pumped back into the lungs, while the blood in need of oxygen was being pumped back into the body, creating his blue pallor.  

To restore oxygenated blood, Richard Ringel, director of the Pediatric Cardiac Catheterization Laboratory at Hopkins Children’s, threaded a balloon-like device through Bryce’s umbilical cord and a chamber of his heart to open and flatten a hole between the two chambers. Seventeen days later when the infant’s lungs were sufficiently healthy, Hopkins cardiac surgeon John Redman switched his arteries into their proper position.

“Both Dr. Ringel and Dr. Brenner spent time with us in the NICU (neonatal intensive care unit) at Hopkins the night he was admitted, carefully detailing the surgery itself and their experience with other children who have undergone it,” says Bryce’s father, Brett Warthen. “Our baby had an inherently fatal condition that could be corrected with surgery. Children who first had the surgery more than a decade ago are leading full, happy lives today, they said, and playing sports. They were just terrific with us.”

In the decade since, Bryce has continued in Brenner’s care, even after his family moved from Maryland to Bluffton, S.C., in 2004, where Bryce today enjoys knee boarding on the May River. “Dr. Brenner knows our son so well and has so much experience in caring for children with rare congenital conditions as they grow that we wanted to ensure Bryce had full advantage of that level of expertise,” says his mother, Tara Warthen.

When, in 2008, Bryce began reporting shortness of breath, Brenner suspected that scar tissue from the child’s earlier surgery could now be impeding his blood flow. So that fall, he underwent a third corrective surgery at Hopkins.

Grateful for Brenner’s enduring care of Bryce and contemplating his eventual move from pediatric to adult specialty care, the Warthens decided to contribute annually to the Division of Pediatric Cardiology to help coordinate such a transition. “We’re entering a new world,” says Tara Warthen, “in which, with advances in medicine, more and more children with congenital issues are reaching adulthood. They’ll need a corresponding bridge into adult medicine.”

“We are so grateful for their continued support and investment,” Brenner says. “My wish is to have an endowed position for a nurse practitioner to help us care for patients as they grow into adulthood.” 

“Our long-term goal,” says Brett Warthen, “is to help foster synergy between pediatric and adult care in the new hospital,” now under construction at Johns Hopkins. “We see it as an investment in Bryce’s future’s, and in the futures of children like him.”