Seattle Children’s

Connection Fall 2010 Where the Heart Is

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Where the Heart Is
Our Heart Center’s team approach and regional presence allow
children to receive exceptional care in their own communities.

Katie Ellis was thrilled to be back near
Tacoma, Wash., where she and her
husband, Joshua, grew up and where
their families still live. After spending
seven years at Air Force bases in
Mississippi and South Carolina where
her husband trained and worked as
a pilot, Ellis was glad to be home —
especially now that they were expecting
their third child.
When Selah Joy was born in May
2009, both parents breathed a sigh of
relief that she was so mellow. As Selah’s
first week of life passed, Ellis was
happy that her newborn was nursing
so well and that her color looked good.
“I did wonder if I was swaddling her
too tight,” recalls Ellis, “when I noticed
that her feet would turn purple and
blue, and sometimes she’d wheeze
and sweat.”
Ellis mentioned these strange
symptoms at Selah’s two-week well-
baby visit. A concerning heart murmur
led their Gig Harbor–based pediatrician
to refer them to Dr. Don Trippel at
Seattle Children’s South Sound
chambers of her heart. The condition,
known as ventricular septal defect
or VSD, is the most common congenital
heart defect, affecting 1 in 500
newborns. Though VSD is repairable
by surgery, Selah’s condition was
complicated by pulmonary hypertension
— a factor that added greater risk to
the surgery.
“Only about 1% of infants are born
with heart problems, so local pedia­
tricians are happy to have someone
with expertise in the community,” says
Trippel. “They rely on us to determine
if something that concerns them is
truly a problem.”
Seamless coordination of care
For three and a half months, Trippel (Above) Dr. Don Trippel is one of two cardi­
ologists at Seattle Children’s South Sound
monitored Selah’s condition from Cardiology Clinics. Only about 5% of his
Tacoma while the family waited for her patients need to go to Seattle Children’s
to reach 13 pounds — big enough to main campus for procedures.
ensure a good outcome from her surgery
(Left) Selah Joy Ellis’ heart was repaired by
at Children’s Heart Center in Seattle. Children’s cardiac surgeons in Seattle, but
“Josh had been deployed to the her ongoing care is at Seattle Children’s South
Middle East during the time we were Sound Cardiology Clinics.

Cardiology Clinics in Tacoma — waiting for Selah to gain weight, so

a mere 10-minute drive from their
pediatrician’s office.
A three-dimensional ultrasound of
Selah’s heart — reviewed on a shared
computer system by both Trippel
and an echocardiography expert at
Children’s Heart Center in Seattle —
confirmed that the Ellises’ pediatrician
was on to something.
The tiny girl had a large hole in the
wall dividing the left and right lower
I was thankful to have Dr. Trippel so
close instead of having to drive to
Seattle for appointments,” says Ellis.
More than 40 pediatric specialists
work together at the Heart Center
in Seattle and regional sites in
Washington, Alaska and Montana to
treat every childhood heart issue —
from congenital abnormalities and
rhythm disorders to heart failure and
transplant.
For out-of-town children like Selah
who need a surgery or procedure that
can’t be done at one of Children’s
regional cardiology clinics, a team of
coordinators works with the family
to set up the appointment and make
accommodations in Seattle, including
airport pickup when necessary. Upon
discharge, the team schedules the
child’s follow-up visits with a Children’s

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 “ Itteens
would be wrong for us not to reach out to children and
Where the Heart Is
in their own communities.”
— Dr. Stanley Stamm, who started traveling around the state in 1964 to see pediatric cardiology patients
cardiologist in their own community
and makes sure that the child’s primary
care provider is kept informed.
“When families come to us looking
for a second opinion, they stay here,”
explains cardiac surgeon Dr. Mike
McMullan. “Our team approach is
different from the way most other heart
centers treat kids. Our medical and
surgical functions at the hospital are
totally coordinated with our cardiol­
ogists out in the communities, so
nothing falls through the cracks.”
“We were so nervous,” remembers
Fall 2010
Ellis, whose husband was given special
permission by his unit to fly home for
the surgery. “But spending time with
Dr. McMullan reassured us. He explained
Connection
everything and he listened well. No
question was crazy for him. He was
In 2009, more than half of the Heart Center’s clinic visits — about 6,000
appointments — took place at sites other than Seattle Children’s main campus:
Seattle Children’s
Seattle Children’s clinics
Other locations where Children’s
Heart Center providers see patients
Seattle Children’s main campus
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just so capable and comfortable to the VSD. Trippel will follow Selah
be around.” throughout her childhood to make
sure that no problems develop.
Understanding families’ needs “We put our trust in Children’s
hands and everything was taken care
Selah’s siblings wanted to see her after
of in the best possible way,” says Ellis.
her six-hour open-heart surgery. “I
“We’ve had exceptional care both in
didn’t think the nurses would allow
Seattle and Tacoma.”
that, but they covered Selah with a
blanket so the kids could see her face
Regional resource for
but not all the tubes,” recalls Ellis.
complex cases
“Then they explained that Selah had
a zipper in her chest — and my other When Siena Hope Magana was born
daughter said she wanted a zipper, in Richland, Wash., what was supposed
too! We were so grateful to have to be the happiest day of her parents’
nurses who really understood siblings lives turned into the worst.
and families.” “As soon as she was born, she was
Today, Selah is a feisty toddler. blue and they whisked her out of the
She no longer needs medication and, room,” remembers her mom Erica
eventually, her heart muscle will grow Magana. “My husband Omar went
over the Dacron patch that covers with her on an emergency transport
helicopter to Children’s.”
Within half an hour after giving birth,
Magana was being driven to Seattle by
her family. On the way, she learned that
Siena was born with a life-threatening
Washington Montana
condition called tetralogy of Fallot —
Bellevue Butte
Bellingham Kalispell a combination of four heart malforma­
Everett Missoula tions that required immediate surgery.
Federal Way In addition, the infant’s heart was
Mt. Vernon Alaska
Olympia Anchorage missing a pulmonary valve.
Port Angeles Barrow “A newborn’s heart is the size of
Silverdale Bethel a ring box,” explains McMullan, who
Sunnyside Dillingham
Tacoma Fairbanks likens Siena’s “unusual and challenging
Tri-Cities Juneau surgery” to “putting a pair of tiny baby
Wenatchee Ketchikan shoes inside that box, cutting a hole
Yakima Kodiak
Kotzebue
in it, then trying to tie the shoelaces
Nome inside the box.”
Sitka Siena was lucky. McMullan and his
Soldotna
colleagues Drs. Gordon Cohen and
Wasilla
Lester Permut are the only cardiac
surgeons in the region who are focused
exclusively on repairing the ring-box-
sized hearts of infants.
Siena has had two surgeries at our
main hospital, but her care is managed
 Have Stethoscope, Will Travel
He is an icon at Seattle Children’s. Stamm began his travels to
Dr. Stanley Stamm was the first Port Angeles, Wash., in 1964,
cardiologist hired in 1962 and only before heart-imaging technology
our second paid physician (prior to was available in the U.S.
the 1960s, community physicians By 1970, Stamm convinced the
volunteered for shifts on the hospital to buy him a van with a lift
hospital’s wards). so he could transport his team —
During Stamm’s 48-year career a cardiac nurse, a new-fangled
at Children’s, he developed the echocardiography machine and an
Whisked to Seattle Children’s main campus
shortly after birth with a complex heart pulmonary and intensive care echosonographer. Before long, their
problem, Siena Hope Magana receives her units, trained thousands of adoring travels extended to pediatric clinics
follow-up care at Children’s Tri-Cities Clinic. clinicians and single-handedly in Bellingham and Yakima and to
started a week-long summer camp the Indian Health Services in
for children with serious illnesses Toppenish, Wash. Eventually, they
close to her home at Children’s Tri-Cities that has been operating for 44 years. started flying up to Alaska.
Clinic, by cardiologists Paul Herndon He was also the father of Today, Stamm’s legacy includes
and Warren Toews. All of Siena’s Children’s Regional Outreach 40 visits each month by Children’s
physicians at Children’s — those on the Program. cardiologists to hospitals and clinics
east and west side of the mountains — “When I started my career in throughout Washington, Alaska and
share her electronic medical records on general pediatrics, I enjoyed making Montana. Our echosonographers
one computer system for immediate house calls,” remembers Stamm. attend every clinic to take images
access to her case. “Once I joined Children’s, it was a of young hearts.
“The clinic in Richland is part of natural evolution to reach out around Stamm, now 85, retired from
Children’s,” says Magana. “Dr. Herndon the state to see cardiology patients.” seeing patients in August 2010.
and Dr. Toews are as good as any of
the doctors at the hospital. They clear
up any confusion we have and explain
everything to us so we understand.”
Magana says she’s thankful for the
doctors and nurses in Seattle, because
they saved her daughter’s life. But she’s
equally thankful for Siena’s doctors in
Richland, because they’re helping keep
the outgoing and playful toddler strong
and healthy.
“Cardiac outreach is a necessity,”
says cardiologist Dr. Stanley Stamm,
who started traveling around
Washington state to see patients
in 1964. “It would be wrong for us
not to reach out to children and
teens in their own communities.”

In 1964, Dr. Stanley Stamm started traveling around Washington state to care for young
cardiology patients, thus unofficially starting Seattle Children’s Regional Outreach Program.
After working together for many years, both he and longtime cardiology nurse Marlene
Dannemiller, RN, retired from Children’s in August 2010.

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