4-year-old undergoes uncommon surgery to fix hole in his heart

Four-year-old Tatum Atherton showed no signs something was wrong with his heart. He was a fireball, hunting, fishing, mudding on his four-wheeler, swimming in a horse trough and conking out by 8 pm. But deep in the recesses of his chest, between the top two chambers of his heart, there was a nickel-sized hole – a very rare congenital heart defect.

To fix it, Tatum and his parents, J.R. and Joyce, traveled from Homosassa to AdventHealth for Children in Orlando, one of the few health systems in Florida that can perform minimally invasive heart surgery for an atrial septal defect.

“God sends you people for a reason, and AdventHealth was sent to us for a reason and that was for Tatum,” Joyce Atherton said.

Dr. Brian Kogon, medical director of congenital cardiac surgery at AdventHealth for Children, explained that instead of traditional open-heart surgery, which requires breaking open the breastplate, he could repair Tatum’s ticker by going in through a small incision under his armpit. He patched the hole with material from Tatum’s heart sack while Tatum was hooked up to a heart-lung machine.

“We are always looking for ways to do open-heart surgery in a more minimally invasive fashion,” Kogon told the Citrus County Chronicle. “The major medical advantage of this approach is that it avoids the risk and complications of opening the breastbone. The other major advantage is cosmetic. The incision is completely hidden underneath the arm. That being said, it can only be used for a small subset of our open-heart operations.”

The defect Tatum was born with only accounts for about 4% of congenital heart defects, and its cause is unclear. The Atherton's pediatrician discovered it during a check-up. Kogon said although children don’t usually have any symptoms, if the hole goes untreated, extra blood in the lungs can eventually weaken the heart, increase blood pressure and lead to heart and lung disease.

The ideal time to operate is between 3 and 6 years old when children are resilient and recover quickly, Kogon said.

Tatum left the hospital after just three days, and with more energy than before.

“He used to run on seven cylinders,” J.R. Atherton laughed. “Now he’s running on all eight.”