Children's hearts

The summer after his first year of med school, Dr. Jeffrey P. Jacobs took a job doing research for a pediatric heart surgeon in Miami. What he saw changed his life.

“I was able to see this surgeon operate on little babies’ hearts,” Jacobs says. “And I knew that was what I wanted to do.”

Since graduating from the University of Miami’s medical school in 1988 — as a doctor of medicine with distinction in research — Jacobs has performed more than 4,000 surgeries, including many heart surgeries on children. He’s transplanted new hearts into babies just 13 days old.

Today, Jacobs is co-director of the Johns Hopkins All Children’s Heart Institute in St. Petersburg, which has performed more than 170 pediatric heart transplants.

Pediatric heart surgery is complex. A typical adult heart is the size of the adult’s first; a baby’s heart, by contrast, is about the size of a golf ball. And it’s not unusual for children to need multiple heart surgeries over time, as they — and their hearts — grow.

Jacobs, who spent seven years in residency at the University of Miami/Jackson Memorial Medical Center and an additional year training at the University of London and the Great Ormond Street Hospital for Sick Children, says there is no better feeling than a successful surgery.

“It’s a field of medicine where we can take a child who’s dying, repair their heart and they could live a normal life,” he says. “What could be a better way to make a difference in life?”

The transplant process begins with a call that often comes in the middle of the night. An infant has died somewhere, and the family has agreed to donate the child’s organs.

Jacobs assembles a team at the hospital. The group gets into an ambulance, which takes them to a Lear jet at St. Pete-Clearwater International Airport. They fly to wherever the donor child is — Jacobs has traveled from Maine to Puerto Rico for hearts — and another ambulance takes them to the hospital where the donor has been prepared in an operating room. Jacobs removes the child’s heart. Everything must be coordinated to the minute with other surgical teams, who will be flying in to remove different organs — kidney, liver, lungs — that will be used to save more children.

As Jacobs removes the infant’s heart, his partner and another team are back at Johns Hopkins All Children’s in St. Petersburg, opening up the recipient’s chest and putting the child on bypass. The diseased heart is removed at the same time Jacobs walks into the operating room with the donor heart.

“The goal is to keep the new heart on ice and not receiving blood flow for less than four hours — certainly less than six hours,” Jacobs says. “Timing is critical.”

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Tags: Healthcare, Economic Backbone, Cardiac Care