Her name means noble strength, and in her short life, Audrey Koch has already done a lot to live up to it. Now, thanks to a unique, collaborative approach among pediatric and adult physicians, Audrey has the potential to prove just how strong she is for years to come.
Amanda Koch was 25 weeks pregnant when perinatologists diagnosed her unborn baby with heart block. Her physician referred her to Sibley Heart Center Cardiology, where pediatric cardiologists suspected long QT syndrome, a disorder of the electrical system of the heart.
Amanda continued to have weekly fetal echocardiograms. At week 30, things took a dangerous turn when her baby’s heart rate went into sustained ventricular tachycardia. On May 11, 2010, Amanda was rushed to Northside Hospital where she would stay for more than a month.
While Amanda’s husband, Mark, along with grandparents and friends, juggled the day-to-day tasks of their other two children and busy end-of-school obligations, their unborn baby fought for her life. Treated by a team of physicians, which included pediatric cardiologists from the Children’s Healthcare of Atlanta Sibley Heart Center as well as obstetricians, perinatologists and adult cardiologists, Amanda and her baby received care that focused on each aspect of the pregnancy and her baby’s heart defect.
Amanda underwent daily fetal echos and was seen by a physician from each team while she was at Northside Hospital. Medication was administered to her baby through Amanda and had to be necessarily adjusted depending on the outcome.
Often undetected, especially before birth, a person’s first sign of long QT is death from sudden cardiac arrest.
“This was a truly unique case. It’s very rare to determine this condition while in utero,” said Margaret Strieper, D.O, Director, Pacing and Electrophysiology, Sibley Heart Center Cardiology. “She was extremely lucky.”
Though worried about her baby, Amanda knew she was receiving excellent care.
“Everyone did a great job collaborating. When you think about it, you have all these doctors who usually don’t work together. You have the obstetricians, who are concerned with successfully delivering a healthy baby. Then there are the perinatologists who are managing the high-risk pregnancy. The adult cardiologists are making sure my heart is OK. And the pediatric cardiologists are managing the baby’s heart condition,” Amanda said. “Everyone had a different priority, but they all worked together to take care of us."
Audrey Claire Koch was born Monday, June 14, 2010.
“There were about 25 people in the delivery room. We were all prepared for what might happen. But she was crying, which was a wonderful sign, and she was pink, which was a great color,” Amanda said. “I think the delivery went much better than anticipated. After she was born, she did become tachycardic again, but because we had planned ahead, the doctors were able to treat her right away.”
At just 2 hours old, Audrey was transferred to Children’s at Egleston, where she was monitored and treated with intravenous medications. Two days later, Amanda got to meet her baby girl.
“One of the nurses put this adorable little dress on Audrey. It was the silliest little thing but it meant so much to me,” Amanda said, her voice breaking. “The nurses knew how much it would mean to this mom who had a new daughter with a long road ahead of her.”
The next day, pediatric cardiothoracic surgeons inserted Audrey’s pacemaker. The surgery was a success, and after spending time in the Cardiac Intensive Care Unit (CICU) and the Cardiac Step-down Unit, Audrey was able to go home with her family.
“We just feel indebted to these people for saving our child’s life. I know they do this every day, but it’s such a gift, such a talent and an amazing service that they provide to families,” Amanda said. “We’re forever grateful.”
Audrey has done well with her medications and her pacemaker. Officially diagnosed with long QT syndrome, this serious disease will take a lifetime of treatment. But with proper medical management of her disease Audrey has a good prognosis.