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Results & Initiatives Story

At the Heart of the Matter

By Chandra Harris-McCray

The Miracle Doctor’ revolutionizes pediatric heart surgery and care

“Moments like these remind me why I cherish what I do and why I keep striving to be a better heart surgeon. In that moment, your world stops and all that exists is that baby.”

—Dr. Christopher Knott-Craig

UT Health Science Center professor and chief of pediatric cardiovascular surgery and co-director of Le Bonheur Children’s Hospital HeHHeart Institute

Moving like smoke, he glides through sterile corridors and elevators. Producing a light breeze as he whizzes past other doctors, Dr. Christopher Knott-Craig gives quick nods of acknowledgement.

He slows his pace as he threads through a family with two young children. Stopping abruptly, he turns to take a quick, more investigative glance, at the young family leaving a routine checkup at Le Bonheur Children’s Hospital Heart Institute.

His eyes lock with his former patient.

Wide-eyed, 7-month-old Brady turns his small, half-moon pout into a grin as he extends his little arms away from his mother. Dr. Knott-Craig scoops him up and begins talking softly in his South African accent, almost in a whisper.

“How have you been?”

Joyfully, Brady’s small palms pat and squeeze Dr. Knott-Craig’s face.

“He is in such a state of awe in your arms,” said Brady’s mother Katie Hazelrigh to Dr. Knott-Craig.

Brady stares in bewilderment at his mother for a few seconds. Then he quickly flashes his gums and goes back to examining Dr. Knott-Craig’s chin, never noticing his primary-colored tie decorated with caricatures of dogs and cats peeking through his white coat.

Back in the arms of his mother, Brady does not take his eyes off the doctor who saved his life three weeks ago by repairing the defects of his heart, which was no larger than his small fist.

Dr. Knott-Craig waves goodbye.

Brady swivels his head and follows his footsteps until he cannot see Dr. Knott-Craig’s face in the afternoon light.

Dr. Knott-Craig continues his brisk walk to the clinic to meet a new patient. But before he opens the clinic’s door, he pauses. He clasps his hands together, as if he is about to pray, and says, “He reached for me because he trusted and recognized me as the doctor who loved and cared for him.

“That is the greatest accolade I could ever receive,” he repeated in amazement.

“Moments like these remind me why I cherish what I do, and why I keep striving to be a better heart surgeon. In that moment, your world stops and all that exists is that baby.

“Brady lives. He did not just survive, but he lives.”

∞∞∞

Treating acutely ill babies and toddlers as if they are his baby girl Cate, Dr. Knott-Craig is revolutionizing pediatric heart surgery and care, not only at UT and Le Bonheur, but around the world.

During his two-year tenure as the institute’s co-director, he has overhauled the practices of the heart institute.

Performing some of the most challenging heart repairs in newborns and infants, Dr. Knott-Craig and his medical team have introduced five high-risk heart surgeries that were not previously performed at Le Bonheur. And for the heart surgeries done before his arrival, the survival rate was less than optimal. Now Le Bonheur averages 36 heart operations a month—slightly more than triple the monthly surgeries performed two years ago.

By the hands of Dr. Knott-Craig, Baby Cole, weighing less than a half-gallon of milk, became one of the tiniest babies ever to successfully undergo surgery to repair his tiny and underdeveloped main artery that supplies blood to the body. Without the procedure to open his artery, which was half the size of a matchstick but should have been the size of a ballpoint pen, he would have died.

In 1994, Dr. Knott-Craig performed the first successful neonatal repair of Ebstein’s anomaly, a rare, often fatal, condition characterized by structural deformity of the valve between the chambers on the right side of the heart—the tricuspid valve.

“Today, the boy on whom I performed that operation is the star running back of his football team,” said Dr. Knott-Craig, while staring at a color photo on his computer of the dark-haired, Oklahoma teenager, who stands almost as tall as him. “He should not have lived, according to science, but now he dreams of making it to the NFL.”

Regularly, triumphing over the medical bar of impossibilities, Knott-Craig echoed the words of one of his mentors: “‘It is not enough to just accept that a problem is impossible to overcome.’”

“Every day feels like 10 years for a parent worried about the heartbeat of their child.”

∞∞

With an office bulletin board of “thank you” cards and pictures, some of babies cupped in nurses’ hands and others all grown-up in wedding gowns and bar mitzvah regalia, Dr. Knott-Craig’s healing process barely begins in the operating room.

“It is never enough for a child to just survive surgery,” he said sternly. “That child needs to survive life. And it starts right here, in my ICU.”

After surgery, the fragility of a baby’s life is cradled like that of a newborn in a mother’s womb.

Not a whimper can be heard on the hospital floor.

Babies bask in low lights, murmured voices, and Mozart’s music. Their eyes are covered with soft eye pads. A pillow or blanket is placed near their heads so the scent of home will be inhaled rather than hospital odors. The feeling of warmth continues as nurses rub their hands together before touching a baby.

With a philosophy rooted in preventing pain, instead of reacting to it, Dr. Knott-Craig makes sure continuous infusions of low-dose medications are given to diminish the trauma that makes recovery from cardiac surgery such a difficult experience.

“Each day is Valentine’s day on my floor,” explained Dr. Knott-Craig.

“For adults, all five senses are fulfilled on that special day of the year. You get roses, chocolate, a stuffed bear, and then you go out for dinner and the opera. You feel the most loved.

“So why should a baby, especially one coming out of cardiac surgery, not feel that same kind of warmth and love?”

Bucking medical dogma that deemphasizes the pain felt by infants and the long-term effects of pain in pursuit of what intuitively makes sense, Dr. Knott-Craig has no doubt that the measures he employs to ease stress and anxiety in a child’s most formative years will lessen the risk of behavioral and relationship problems later in life.

“It is about protecting that trust between a parent and their child,” he said. “If that trust is broken in the first days of a child’s life, do you not think that will alter the way that baby heals and ultimately forms bonds and relationships later in life?

“It is absolutely imperative that a child is cared for emotionally and spiritually. That means creating an ICU setting favorable to healing and developing.”

Dr. Knott-Craig dreams of the day when video cameras can be installed in the ICU rooms “so a mom and dad can tend to their other children at home,” he said, “but still be able to keep a watchful eye on their new little one.

“You will be hard-pressed to find another hospital in the world doing what we are doing here.”