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By New Times
By Connor Radnovich
By Robrt L. Pela and Amy Silverman
By Ray Stern
By Keegan Hamilton
By Matthew Hendley
By Monica Alonzo
By Monica Alonzo
A dynamo with a winning smile, Xzavion seems the picture of health, if a bit small for his age. But the boy's heart is very sick, and if Dr. Teodori doesn't fix it properly, the 3-year-old's life will be tragically short.
Xzavion had shown signs of congestive heart failure immediately after his birth at Samaritan Regional Medical Center in July 1998. Tests revealed he'd been born with aortic valve stenosis (AVS), in which blood can't flow freely between the left ventricle and the aorta.
When Xzavion was a day old, a doctor inserted a kind of balloon to open the bad valve. The procedure is considered a stopgap measure to keep a child alive until surgeons may attempt a potentially more lasting operation, the Ross, some years later.
But Xzavion had to have a replacement balloon implanted when he was just four months old. It achieved far better results, and subsequent testing by a machine that examines the heart with powerful ultrasound equipment was positive.
Then, last Christmas Eve, Xzavion collapsed while playing outside with other kids. He was unconscious for a few seconds, then, his mother says, "He was back to himself in an hour or two."
In April, cardiologist Dudley Halpe told Samantha Blier that the bad aortic valve was 70 percent closed, compared with the 40 percent closure of just a few months earlier. That put the little boy in immediate peril.
Dr. Halpe recommended the Ross operation, and that the best surgeon to perform it was Mike Teodori. But Xzavion Gonzales is a CRS patient, and as such was supposed to be treated by doctors at St. Joseph's Hospital.
However, Dr. Bill Peoples says he, Halpe and other cardiologists had continued to refer their most complex patients to Teodori, whether the child was CRS-eligible.
"I have no trouble trying to work within a program," Peoples says, "but there are degrees of complexity. The ultimate result is my only concern, and if I think that Mike Teodori -- who is technically the best of any pediatric heart surgeon here -- is the guy to do the job, then I'll send a case to him."
Recalls Samantha Blier, who works as a cashier at a Phoenix Wal-Mart store, "I just asked Dr. Halpe who he would want to operate to perform heart surgery if one of his own children needed it," she says. "He said Dr. Teodori. I said, That's my guy, then, CRS or no CRS.'"
At the April meeting with Xzavion and his family, Mike Teodori explains that Xzavion has gotten as much mileage as possible out of his bad aortic valve. Samantha Blier replies that her son is tiring more and more easily, though he keeps trying to keep up with other kids.
"His adrenaline is working like he's walking fast all the time," the doctor continues. "Or like he has to jump over a hurdle every few steps when he's just walking."
Teodori lifts an oversize plastic heart from a shelf as a teaching tool. He describes how heart valves are thin leaflets of tissue which open and close like a one-way door during each heartbeat. Their main job, he says, is to keep the blood from flowing backward into the heart.
The pulmonary valve directs blood from the heart into the lungs, while the aortic valve pumps it into all parts of the body.
"For the first time in his life, he'll have a normal valve," Teodori tells Blier. "He'll have more energy than ever."
"Oh, no," she replies, kidding.
"This is a big operation, a lot of work," Teodori says, "but with an excellent chance of a good result for life. I've done over a hundred of these, and I've had beautiful results. There are surgeons at St. Joe's who could do this, too. But if you want me to go ahead, I'll be glad to."
"Yes, I would," Blier says. "But what's the risk?"
"About 3 percent," Teodori replies.
He warns Blier that the Ross surgery won't cure Xzavion's defect, and says the boy probably will need another pulmonary valve when he's an adult. But, the doctor adds, Xzavion's quality of life and his life expectancy should increase dramatically after the upcoming operation.
"The chances are excellent," he says, "that Xzavion goes home in about four days with his heart working like it's never worked before."
"He's gonna make your heart better," Blier tells her son, who is fiddling with the big plastic heart.
"It's going bye-bye -- my heart," Xzavion says.
Teodori asks Xzavion to sit by him.
"Make a muscle for me," he asks the boy.
Xzavion scrunches up his face, and gives it his best shot.
Teodori feels a bicep, then nods as if duly impressed.
"After I fix your heart, it's gonna be even stronger," Teodori says. "Are you scared?"
"You're a special little boy. I think you're just a borrowed angel. You're going to be special to people for a long, long time."
Seeing Mike Teodori perform surgery is akin to listening to a world-class jazz musician engaged in his craft. Teodori and his "bandmates" -- everyone in and out of the operating room -- tackle intricate tunes that only superior players can execute with any acuity.