September 6, 2012

Patient’s odyssey takes her from Japan to Vanderbilt

Cylinda Marquart gripped the small Post-it note inscribed with Japanese characters as her 6-week-old daughter, Albi-Helene Martin, was raced to a hospital by ambulance.

Cylinda Marquart gripped the small Post-it note inscribed with Japanese characters as her 6-week-old daughter, Albi-Helene Martin, was raced to a hospital by ambulance.

Albi-Helene Martin and her family traveled from Japan for the young girl’s heart surgery at the Monroe Carell Jr. Children’s Hospital at Vanderbilt. (photo by Susan Urmy)

Moments earlier, a Japanese doctor had jotted down the characters, naming a possible heart defect. His concerned look alarmed Marquart, making her feel that something was wrong.

Though able to speak Japanese, her knowledge of medical terms in the language was limited, so she emailed her husband, Steven. She tried to understand how what doctors initially thought was a heart murmur could have escalated.

The tiny characters set in motion a series of events that would send the family across the Pacific Ocean, separate a father from his wife and daughter for nearly a year and create lasting connections in Nashville.

Albi, named for the city in France where her parents were engaged, was born with transposition of the great arteries of the heart (TGA). With transposition, the aorta and pulmonary arteries are switched. Instead of pumping oxygen from the lungs to the rest of the body, the vessels carry the oxygen from the lungs to the heart and back.

She had heart surgery in March at the Monroe Carell Jr. Children’s Hospital at Vanderbilt. After months of growing, healing and building relationships, Albi and her mother recently returned to Tokyo.

“It was a difficult decision to come here. There was so much unknown, in every aspect,” said Marquart. “When we came here, we were very frantic still from the earthquake, the tsunami, then having to relocate and everything with Albi.”

Albi was born weeks after the 2011 earthquake/tsunami/nuclear meltdown in Japan. Her parents, U.S. born natives, had lived there eight years. Albi and Marquart temporarily relocated to Fukuoka, the southern region of Japan, after the disaster.

Albi had emergency surgery the day her condition was discovered, and a second surgery after that to place a Blalock-Taussig shunt, or BT shunt, to help with blood flow and oxygen to her body.

Bret Mettler, M.D., talks with Cylinda Marquart and her daughter, Albi-Helene Martin, during a recent clinic visit. (photo by Susan Urmy)

But additional procedures in Japan would only offer temporary care until a more permanent repair could be done. Her case was complicated and risky. By chance, Marquart’s sister, Felicitas Koller, M.D., was a chief Surgery resident at Vanderbilt at the time, and consulted with Bret Mettler, M.D., director of Pediatric Cardiac Transplantation and assistant professor of Pediatric Cardiac Surgery, and David Parra, M.D., assistant professor of Pediatric Cardiology.

“My sister said ‘please come; come,’” said Marquart. “She was like ‘We can do this here, we can do this at Vanderbilt.’”

At five months old and weighing 12 pounds, Albi arrived in Nashville in October 2011.

“Once we made the leap to come to Vanderbilt, the amount of coordinated effort to help us was amazing. Everyone was so proactive, throwing their proverbial arms open to us.”

In March, Mettler performed a Rastelli procedure on Albi — an extensive open heart surgery to reroute the left ventricular blood flow to the aorta and used a conduit to reroute right ventricular blood to the pulmonary artery. The Japanese doctors’ skillful work had already set the stage for a successful operation.

Albi will need future surgeries, but is thriving, babbling and starting to walk.

On her last followup visit, Albi clasps her hands, gazes up at the pediatric heart clinic staff and bows her head when her mother utters, “xie, xie,” Chinese for “thank you.” Her parents speak English, Chinese and Japanese, which she understands.

“Okay Albi, you’re going to be perfect,” Mettler said to Albi, now weighing 20 pounds. “She won’t need anything I suspect for several years.”

With her wide brown eyes, and signature coiffed hair, the 15-month-old thanks her doctors, nurses and a host of people in Tennessee who helped her.

“The amount of care, kindness and support has been overwhelming,” said Marquart. “It is as if we are truly part of a family. At every step, I’ve been deeply touched by everyone’s kindness and willingness to ‘just help.’ It’s kind of hard for us to go.”