On March 9, 2015, Riley Marie Chastain became one of fewer than 20 babies to be delivered in a Riley Hospital operating room. Heart surgeon Mark Turrentine, M.D., knew there was no time to transport her from a nearby maternity hospital. He had just minutes to operate to save baby Riley’s life. One hour later, the newborn began a three-month stay in the cardiac intensive care unit (CVICU) at Riley Hospital. Her medical team would combine all its skills and resources to help her overcome daunting odds.
Christopher Mastropietro, M.D., medical director of the CVICU, served as the primary intensivist on Riley’s case. He points out that the average stay in the unit is three days, and most patients leave within a week. Riley Chastain was among “the sickest of the sick.”
Rob and Katie Chastain of Greenwood, Ind., had learned in November 2014 that their baby would be born with a severe cardiac problem: hypoplastic left heart syndrome, a birth defect that affects normal blood flow through the heart. They later learned she also had an intact septum, the absence of a hole between the two upper chambers. The Chastains saw Riley Pediatric Cardiologist Anne Farrell, M.D., who estimated their daughter’s chances of survival at about 10 percent.
Doctors formulated a detailed plan for Katie to deliver via C-section in an operating room at Riley Hospital. Although Riley has begun to build a comprehensive Maternity and Newborn Health program, at this time mothers do not routinely deliver at Riley. The Chastain baby would become one of fewer than 20 born at Riley Hospital since it opened in 1924.
In this situation, however, time was critical. “We know that if she would not have been able to be born [at Riley], she wouldn’t have lived past her first day,” Rob says. Baby Riley was immediately taken to the cardiac catheterization lab, where pediatric surgeon Mark Turrentine, M.D., created the essential hole between the upper two chambers of her heart.
Ten days later, Dr. Turrentine performed the first phase of complex open-heart surgery that would allow Riley’s heart to pump blood to her body. She came to the cardiac ICU from surgery on ECMO (extracorporeal membrane oxygenation), in which a machine takes over the work of the lungs and heart. However, complications forced physicians to remove the support. Over the next week, Riley’s condition deteriorated and family members prepared to say goodbye.
But then doctors gave her one more chance on ECMO. Sometimes physicians simply follow their instincts, Dr. Mastropietro says. “I told Riley’s mother, ‘There’s no book on a lot of these kids—there’s no book on Riley Chastain.’”
Doctors were able to get Riley off her second ECMO course after 16 days. Despite additional setbacks, Rob and Katie realized their dream on June 15: they brought their baby girl home.
Riley Hospital is the largest tertiary care referral center in the state. More than 95 percent of cardiac procedures done on children in Indiana occur at Riley. So although he sees hundreds of patients each week, “I’ll always remember Riley Chastain,” Dr. Mastropietro says.
And the Chastain family will always remember the compassion that made their daughter’s harrowing journey easier to endure. “The scary nights where she was crashing, there was always someone who would grab a chair for me and make sure I sat down, or got me water,” Katie recalls with gratitude. “Everybody at Riley has been wonderful.”
It took a team of experts working together to save Riley, from skilled and compassionate nurses, to cardiology team members, to ECMO technicians to intensivists. But Dr. Mastropietro also credits the baby’s perseverance—and something else: “She is blessed with wonderful, nurturing family environment. That’s the most important thing for these children to live relatively normal lives. That’s the hope for her long term.”