How a Baby in Heart Failure Received a New Heart in the Midst of the Pandemic
Nine-Month Old Alexandra Is Thriving After a Complex Journey
Alexandra Lovo Lopez had been hospitalized for more than half of her young life when she received a new heart at Mount Sinai Kravis Children’s Hospital on Thursday, July 9, making her one of two pediatric heart transplant recipients in the tri-state area since the COVID-19 pandemic took root.
Alexandra, a nine month old toddler from Queens, was admitted on March 19 (she was just four months old upon admission) with severe heart failure and was diagnosed with dilated cardiomyopathy, a rare condition that affects infants and children that causes weakness of the heart muscle making it difficult to pump blood properly.
“Her care was extremely complex and she was very sick when she arrived more than four months ago. Even in the best of times, heart transplants for babies are challenging, but the pandemic added a series of hurdles,” says Robert Pass, MD, Chief of Pediatric Cardiology, Mount Sinai Kravis Children’s Hospital.
At the time of Alexandra’s admission, pediatric doctors, including pediatric cardiologists, were being redeployed to care for adults with COVID-19. “We were mindful to balance the needs of adult patients who were seriously ill with the needs of Alexandra, who required complex critical and cardiac care,” Dr. Pass says.
On March 25, her team of doctors implanted a device called the Berlin heart, which would provide mechanical support for her heart while they searched for a donor heart. Implantation of the Berlin heart required a procedure in which Raghav Murthy, MD, Surgical Director, Pediatric Heart Transplant, Mount Sinai Kravis Children’s Hospital, opened the chest cavity to implant the device that pumps blood from the left ventricle, sending blood to the aorta and thereby alleviating the burden on her weak heart.
During her four-month stay, Alexandra was cared for in Mount Sinai’s Pediatric Cardiac Intensive Care Unit (PCICU), run by Scott Aydin, MD, Medical Director, Pediatric Cardiac Intensive Care, Mount Sinai Kravis Children’s Hospital. “When Alexandra came to us, we knew she needed to grow stronger and feed better, so we placed her on the Berlin heart, which made her extremely vulnerable to infections and strokes. Our multi-disciplinary critical care team was obsessively vigilant during this time, especially with COVID-19 occurring all around us. Even once transplanted, she was immuno-compromised because of all her medications, thus we had to remain extremely guarded and careful,” says Dr. Aydin.
Many months later, on July 9, Lauren Glass, MD, Medical Director of Pediatric Heart Transplant, Mount Sinai Kravis Children’s Hospital, identified a heart from another state. But there was a hitch. The heart was ABO incompatible, meaning the donor had a different blood type. “She would require several transfusions of new blood to facilitate a whole-blood exchange,” says Dr. Glass. “Our blood bank staff worked around the clock to ensure an adequate supply for Alexandra,” says Dr. Murthy.
The donated heart needed to be checked and rechecked to ensure that the donor had not been infected by COVID-19. After it was determined that the heart would be a safe match for Alexandra, the team proceeded with the transplant surgery, led by Dr. Murthy. “We were quite pleased. Her new heart started working well right away. In the days following her surgery, as we realized the transplant had been a success, it was like a ray of sunshine on all of us,” says Dr. Murthy.
“The successful heart transplant of Alexandra is a testament to the teamwork that is routine at the Children's Heart Center at Mount Sinai Kravis Children’s Hospital. She is healthy and home today thanks to the unparalleled and excellent care she received in our Pediatric Cardiac Intensive Care Unit, led by Dr. Aydin and his extraordinary staff of compassionate clinicians. Finally, we were able to leverage the knowledge and experience of two transplant experts in our center, Dr. Glass and Dr. Murthy, who, together, took such fabulous care of this once-fragile infant, resulting in the wonderful outcome we see today. I feel profoundly lucky to work in a center where we all share one important goal: the best possible outcomes for our patients,” says Dr. Pass.
"Alexandra is doing very well and we couldn’t be happier for her and her family who have waited so long," says Lauren Glass, MD, Medical Director of Pediatric Heart Transplant, Mount Sinai Kravis Children’s Hospital.
“Alexandra is our miracle baby. It was our privilege to see this transplant through in spite of so many hurdles and so many months of waiting,” says Dr. Aydin.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in 4 out of 10 pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: It is consistently ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and top 20 in the nation for National Institutes of Health funding and top 5 in the nation for numerous basic and clinical research areas. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.