A Homestead infant, born prematurely with a caved-in chest and lacking a full rib cage, gets a second chance when surgeons implant metal mesh into her chest.
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Thanks to the medical ingenuity of surgeons at Baptist Children's Hospital in Kendall, a premature infant the size of a cantaloupe who was born with only half a rib cage is coming home from the hospital Wednesday -- and breathing on her own.
The infant, Kaylee Holler, now 2 months old, was born with a severe form of a rare birth defect that had left her with only six ribs where 12 ribs are normally found. Instead of those ribs curving around her chest to connect with her breast bone, she had short, stubby ribs, causing her chest to cave in.
''She basically couldn't breathe [because] her ribs were so malformed,'' said Dr. Juan Sola, the pediatric surgeon who performed the two-hour operation.
Sola was stumped, however, because of her size. Kaylee weighed only 3 pounds 7 ½ ounces when she was born Aug. 24 at Homestead Hospital. She was nine weeks premature -- the size of a cantaloupe, Sola said. Her left lung was smaller than the right, adding to her breathing problems.
''Every time she would try to breathe on her own, her chest collapsed,'' said Dr. Paul Fassbach, the neonatalogist who put the infant on a respirator to help her breathe.
Sola called Johns Hopkins University in Baltimore, where he attended medical school, and several other medical doctors for advice.
''Nobody [had] had to fix a baby this age,'' he said.
''It was really kind of an unknown all the way around,'' Fassbach added.
After meeting with a manufacturer of titanium material normally used to replace hip joints and sections of missing skull, Sola and fellow surgeon Dr. Donald Buckner concluded they could create a makeshift rib cage for Kaylee.
''The mesh would cover the lung and bridge the gap and looked like it might work,'' Sola said. ''Once we had what we thought was a reasonable implant, we thought it would work. This was the best idea we had to stabilize her chest,'' Sola said.
A 3-D CAT scan provided a road map of the area to be reconstructed. After the operation on Oct. 11, the caved-in chest was gone, replaced by the titanium rib cage. The only evidence: a tiny two-inch scar.
Now, Kaylee and parents Michael and Mitzi Holler are looking forward to Wednesday, when she goes home for the first time.
KAYLEE'S BIRTH
Dad Michael Holler, a 25-year-old forklift driver, said he knew something was wrong as soon as Kaylee was born by Caesarian section.
''I knew something wasn't right,'' he recalled. ``Her whole chest was caved in.''
Mitzi saw the look on his face and her heart sank.
''I looked over at him,'' she said. 'He said, `Something is wrong.' ''
While Mitzi Holler stayed at Homestead to recuperate from the C-section, doctors moved Kaylee to Baptist Children's neonatal unit.
They had never seen such a severe case of Poland Syndrome. The condition, named after a British doctor who classified the anomaly in 1839, affects only the right or left sides of the body at one time. Those born with it are missing the chest muscle -- the pectoralis major -- normally attached to the breast bone.
MORE SURGERIES
Kaylee's operation won't be her last. Sola said she'll need several surgeries as she grows and her rib cage expands.
She will be on oxygen for another two to three months, and they will have monitors at home to keep track of her breathing.
''For a long time, I didn't even know if I had a hope,'' Mitzi Holler said. ``It was just so hard. She would stop breathing four or five times a day.''
Michael Holler's reaction when Sola suggested trying something so rare: ``They didn't know for sure if it would work, but we wanted to try it.''
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