Children’s Hospital Los Angeles (CHLA) recently performed its first dextrocardia heart transplant. The child, known as Baby Ruben, was born with dextrocardia and complex heterotaxy syndrome—including a single ventricle and discontinuous pulmonary arteries, along with other defects. The child received a heart transplant at CHLA at 2 years of age.

An animated graphic illustrates the “before and after” of the surgery. The graphic first shows the original, pre-operative heart, which was sitting backwards in his chest, pointing toward the right side of the chest instead of the left. The second image shows the same heart after CHLA cardiothoracic surgeons completed a Glenn procedure (the second of three HLHS palliative surgeries). The final images show the new, transplanted heart—with the misplaced blood vessels rearranged to accommodate the normal donor heart.

“I tell my trainees all the time, ‘You don’t get to complain about complex anatomy,’” says Dr. Cynthia Herrington, Surgical Director of the Heart Transplant Program at CHLA. “Because that’s what we do. This is what we thrive on here.”

“It was all doable,” says Dr. Herrington, who had performed one other dextrocardia transplant earlier in her career. “We just took the steps and walked through.”  

Dr. Sarah Badran, one of Ruben’s CHLA cardiologists, watched much of the surgery and describes it differently. “It was a massive reconstruction to fit a normal-shaped heart in a backwards space,” she says. “The way she brought the liver and inferior vena cava veins over, the amount of extensions she had to use to make things connect and not be twisted—it was amazing. I don’t know of a lot of surgeons who could have done that.”