By Erica Gadbois
When he was born, Dylan King, 18, “weighed eight pounds, 13 ounces and seemed to be thriving,” recalls his mom, Kathleen King. At his one-week checkup, however, his pediatrician detected a heart murmur. “He said that because Dylan seemed so healthy … it was most likely something minor that would resolve on its own,” Kathleen explains. Still, to make sure all was well with the newborn, the pediatrician referred him to Rady Children’s Hospital-San Diego for an echocardiogram.
It was here that Kathleen and Dylan’s father, Christopher King, learned their son’s murmur was the result of multiple congenital heart defects (CHDs). These included dextrocardia, in which the heart faces the right side of the chest rather than the left; pulmonary stenosis, in which arterial narrowing obstructs blood flow from the right ventricle to the pulmonary artery; and single ventricle, in which one of the heart’s lower chambers is underdeveloped and unable to effectively pump blood. Physicians told the Kings that Dylan would need a minimum of two open heart surgeries before his second birthday. “His first … occurred when he was three months old and his second when he was 22 months,” says Kathleen. “He [also] had a third surgery when he was 3-and-a-half; a thoracic surgery to remove part of his lung that had become complicated with too many collateral vessels.” All surgeries were performed at Rady Children’s.
For years after, Dylan was able to live life like a typical kid and found a passion in sports — especially baseball. “His cardiologist suggested that we introduce him to low-aerobic sports … [Christopher and I] both played ball when we were younger, so we signed him up for T-ball when he was 5 … he has been playing baseball ever since,” Kathleen comments. “His heart defect was never a detriment to his everyday life.” When he was 13, however, Dylan fainted while running in P.E. class, knocking out his two front teeth in the process. After extensive testing, results were, in some ways, a relief — there was no evidence of anything wrong. But concern lingered. Had this just been a fluke? Or was there a problem lurking?
Fast-forward to Feb. 5, 2018. While hanging out at home with his family, Dylan, just 17, went into cardiac arrest and was rushed to Rady Children’s. He was diagnosed with severe heart failure and placed on extracorporeal membrane oxygenation (ECMO) under the care of John J. Nigro, M.D., director of Rady Children’s Heart Institute and clinical professor of surgery at University of California San Diego School of Medicine, and the cardiac intensive care unit team. During Dylan’s week on ECMO, which supports heart and/or lung function in the event of severe failure, the Kings were dealt another blow. Dylan needed a heart transplant.
The family met with Rakesh Singh, M.D., M.S., medical director of the Hospital’s pediatric heart failure and transplant program and associate clinical professor of pediatrics at UC San Diego School of Medicine, and colleagues to plan. “Learning that Dylan would need a transplant was overwhelming and incredibly scary, but after watching him on the verge of death, we were open to anything,” says Kathleen. “We had a very in-depth meeting with the transplant team and learned all of the details of what was in store.”
“Dylan already had one near-death experience, and we knew we had to keep him safe going forward,” adds Dr. Singh. “A heart transplant was the best option to give him a chance to live a long, healthy life.”
For Dylan to be placed on the transplant list, providers determined he first needed to regain his strength and prepare his body as fully as possible. He spent five weeks recuperating in the Hospital — a relatively short timeframe, which was credited to his level of physical fitness from playing baseball — and was officially listed on May 7. That wasn’t before he was evaluated for a potential liver transplant as well. One of his reconstructive surgeries, the Fontan operation, is standard-of-care for youth with a single ventricle CHD. As effective as it is in improving outcomes for this complex and life-threatening condition, the procedure is known to almost universally cause some degree of damage to the liver, a result of increased pressure within a patient’s veins. Fortunately, Dylan’s biopsy results were healthier than anticipated.
While waiting for a heart, Dylan wore a defibrillator vest around the clock, which would restore function to his heart should it stop again. He returned to school to complete his junior year, and although he wasn’t cleared to play baseball, he attended every game to support his teammates. While cheering on his friends, he donned his uniform, which his varsity coach brought to him during his cardiac arrest recovery to ensure he kept his signature jersey number — 8. “Dylan’s very first baseball number was 8,” explains Kathleen. “Then, as a freshman in high school, he was thrown the number 8 jersey by chance, and from then on, his nickname was ‘Ocho.’ While we were waiting for the transplant notification call, we were kind of joking, ‘wouldn’t it be weird if you got your heart on the 8th?’” As fate would have it, he did. On July 7, Dylan was matched with a heart, and underwent the transplant surgery with Dr. Nigro the next day. “We got a call from the operating room at 8 a.m. on the 8th that the new heart was beating in his chest. It’s his lucky number!” Kathleen exclaims.
After a three-week hospital stay, Dylan returned home and kept up with his schoolwork from afar until he was given the go-ahead to return in October. “During this time, we met regularly with the transplant team; they were and are an amazing team,” Kathleen expresses. “We feel so fortunate to have access to such dedicated and compassionate doctors and staff … we have always felt supported and informed.”
Now back at school full-time, Kathleen says Dylan is “counting down to his graduation” in June. He has also returned to the baseball field for team workouts over the past several months, which has helped him recover and start enjoying a well-deserved return to normalcy. His body has accepted his new heart and it’s going strong — as is Dylan himself. “It has been a lot to take in this past year,” muses Kathleen. “He and I were talking about it the other day, and I told him that he has handled everything so gracefully and that I was incredibly proud of him. His response was that he was only doing what he was supposed to do.”
Published February 2019