Transposition of the Great Arteries: Ian's Story
Ian Street spent the first two weeks of his life surrounded by a team: his parents and the doctors and nurses of the Cardiac Center at The Children's Hospital of Philadelphia.
Born with a severe heart defect called Transposition of the Great Arteries (TGA), Ian was taken by helicopter to Children's Hospital a few hours after his birth.
There, Jonathan J. Rome, MD, performed an emergency catheterization technique called balloon atrial septostomy, 
a procedure first developed at The Children's Hospital of Philadelphia by William J. Rashkind, MD. Ian's father, Ron, drove to Children's Hospital to be with his baby.
But Ian's mother, Christine, having just given birth, wasn't able to get there. That night, Gil Wernovsky, MD, a Cardiac Center cardiologist, called her at the maternity ward and explained the procedure her baby would need. Once it was concluded, he called to tell her Ian was stable.
The Streets found this standard - the best clinical care, combined with thoughtfulness and good communication - throughout Ian's two-week stay in the Hospital and in the 12 years since as he has visited as an outpatient.
"I would never have gotten through this experience without the people at CHOP," she says. "They helped me in from every aspect, from to teaching me to take care of him to helping me learn how to nurse him. It's just an amazing, amazing group of people."
Ian spent several days in the Evelyn and Daniel M. Tabas Cardiac Intensive Care Unit (CICU). Then Thomas Spray, MD, performed surgery to move the heart's main arteries into their correct positions.
The wait during surgery "seemed like forever," Mrs. Street recalls. But their anxiety was alleviated by the team's efforts to explain the surgery and put them at ease, as much as possible.
Dr. Wernovsky explained the procedure numerous times in the days leading up to surgery. "Our son's heart was the size of a plum and the vessels that were reversed were the size of lead in a pencil," Mrs. Street says. "Everything is extremely intricate and extremely tiny."
The Streets met with Dr. Spray before the procedure. Anesthesiologist Susan Nicolson, MD, came to Ian's bed and accompanied him to the operating room.
"You know almost everyone who is with your child," Mrs. Street says. "He's not just going into unfamiliar territory. Everybody had a specialty but they all worked together."
Soon after the procedure, a nurse came to the Streets and told them wonderful news: "We got word that he was doing great. That's all we really needed to hear."
One of the most difficult experiences was to see Ian after the surgery. His incision was covered in bandages and ran nearly the length of his chest and he was heavily sedated. "That was the scariest part," Mrs. Street recalls. "At first we couldn't even hold him. He was hooked up to so many things."
But he improved quickly. "At some point we were able to hold him," she says. "We needed to hold him as much as he needed to be held." Mrs. Street, who had met with one of the Hospital lactation consultants and had been using a breast-pump, was also able to breastfeed him for the first time.
During this difficult time, Mrs. Street remembers the Cardiac Center nurses as incredibly helpful. The Streets stayed with Ian as much as possible, but spent some nights at home. They would call Ian's nurse before they went to bed, to make sure he was OK.
The nurses played music for Ian on a radio next to his bed. One morning the Streets walked in to find him wearing a soft new hat, a gift from one of the nurses. "The nurses were spectacular," Mrs. Street says. "Over-the-top nursing. I've never met so many caring and skilled people in my life. That really helps to get you through."
Ian spent two weeks in the Hospital. Born Dec. 2, he finally came home Dec. 17, "making him the best Christmas gift that we will ever receive," his mom says.
His recovery continued and he had numerous checkups at the Hospital in the first year.
Today Ian is 11 and in fifth grade. He has a checkup with Dr. Wernovsky every two years, including an electrocardiogram and an echocardiogram.
Children born with TGA can experience leaky heart valves and other cardiac problems, so Ian will continue to see a cardiologist for many years. His primary care pediatrician is also well-versed in Ian's story and knows what to look for during regular checkups.
So far, there have been no problems. Ian is an excellent student and hasn't experienced developmental delays, as some cardiac patients do. He is very athletic; his sports include baseball, swimming, soccer, tennis, basketball and golf.
The Streets went on to have two more children, both born healthy. While Mrs. Street remembers the fear and stress of Ian's first days, she also remembers the good: Cardiac Center nurses and doctors and the support and care they provided.
"We're so lucky that CHOP is basically around the corner," Mrs. Street says, "The care was just first-rate - extremely caring, sympathetic, skilled, intelligent and dedicated people. I couldn't have asked for anybody better to leave my baby with."
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