A hole in her heart

Girl survives against odds

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Editor's note: This story is the first in a three-part series. Check the Steamboat Today on Monday and Tuesday to read more.

It was news no parent wants to hear.

Doctors at Presbyterian/St. Luke's Medical Center in Denver told Audrey and Shawn Zwak that their new daughter, their third child, their Ellie, had a 1 percent chance to live.

A little more than 8 months old, Ellie had just gone into cardiac arrest after six hours of open-heart surgery.

Her heart stopped. A surgeon pumped the tiny, patched-up organ by hand. Doctors didn't think she would survive another hour, let alone leave the hospital.

But sometimes 1 percent is all it takes.

Ellie Ann Zwak came home three weeks later, on Dec. 22, 1999 -- six years ago Thursday. That day is her mother's birthday, three days before Christmas.

Now 6 years old, Ellie is a first-grader at Strawberry Park Elementary School. Because of an oxygen shortage in her brain during the cardiac arrest, she is legally blind and has difficulty developing muscle tone. She has used a wheelchair her entire life.

But none of that has stopped Ellie from dancing in gym class, singing carols during physical therapy and getting Christmas presents from boys in her class.

In a three-part series beginning today, the Steamboat Pilot & Today will tell Ellie's story.

Dr. David Miller, a cardiologist who was in the operating room that night and who still sees Ellie once a year for check-ups, said, "She is a kid I'll never forget."

As you learn about her resilience, humor and love, we doubt you will forget Ellie, either.

A hole in her heart

When the Zwak family came home to Steamboat Springs for Christmas six years ago, they found their living room filled with presents.

But parents Audrey and Shawn, daughter Hannah and son Sam cared most about one, incredibly special gift -- little baby Ellie, who somehow had survived.

It had been a long road.

A day after Ellie Ann Zwak was born in March 1999, she flew to Denver with her parents for a heart catheterization, or temporary repair of her heart.

A valve in newborn Ellie's right artery was too narrow for adequate blood to get through. The right artery moves blood to the lungs.

"She was fairly blue in color," said Dr. David Miller, a pediatric cardiologist based in Denver. Miller has been Ellie's cardiologist since she was born and participated in the initial surgery. "Stretching and tearing open that valve removed resistance and gave us the luxury of waiting a little bit (for permanent surgery), until she was older."

Ellie would be diagnosed with "Tetralogy of Fallot," a heart problem characterized by four ailments, including a hole between the two blood-pumping ventricles and a narrow artery.

Her permanent heart surgery took place Dec. 3, 1999. It lasted six hours.

Miller said the surgery had two components: widening the artery and putting a patch, made of medical-grade cloth, over the hole in Ellie's heart.

The surgery went well; Ellie's heart was sewn together.

Then it stopped beating.

One hour, 45 minutes

Ellie's cardiac arrest happened suddenly.

"Usually, when patients need that level of support, we can see it coming," Miller said. "In Ellie's case, we didn't have a warning."

When her heartbeat flat-lined, Dr. David Clark began performing cardiac massage, literally pumping the tiny heart of an 8-month-old girl with his hand.

He pumped for 10 minutes, then 20. Then more.

"When she flat-lined, the surgeon pumped her heart for 45 minutes," Audrey Zwak said. "He looked at his watch like he was about to stop."

Miller said after so much time, the likelihood of debilitating, permanent damage greatly increases, and chances of survival rapidly fall.

"We were very close to deciding maybe we should stop," Miller said.

The little girl had other ideas.

"Then Ellie opened her eyes and looked at him," Audrey Zwak said.

Miller, on hand while Clark pumped, recalled the moment.

"A little child opening their eyes and looking at you -- you have to think, 'Let's continue on and try to allow her to recover,'" he said.

An hour later, after one hour and 45 minutes, Ellie's heart beat on its own, and she was placed on life support.

"She just fought and fought -- she wouldn't give up," Audrey Zwak said.

Ellie stayed in the hospital for three weeks. For two weeks, she was in a coma, her mother said, and they could see her heart beating for six days through a little clear patch on her chest. But she lived, and made it home for a very special holiday.

"We always send the heart surgeon a Christ--mas card," Audrey Zwak said.

"It says: 'Next time go an hour and 46 minutes.'"

A different Christmas

Audrey Zwak is director of the Heritage Park Preschool in Steamboat. Shawn Zwak, a former police officer, is a full-time firefighter at Yampa Valley Regional Airport in Hayden.

Six years ago, while Ellie was in the hospital recovering, Shawn and Audrey Zwak stayed with her in Denver. Seven-year-old Hannah, now 13, and 4-year-old Sam, now 10, spent as much time in the hospital as they could while staying with friends and relatives.

When the family finally made it home to Heritage Park, a surprise was waiting for them.

"There was a Christmas tree in the living room and piles of presents," Audrey Zwak said.

Firefighters and police officers with whom Shawn Zwak worked had gone into the house, put the tree up, decorated it and bought presents for the Zwaks while the family was in Denver watching over Ellie.

Audrey smiled at the memory this week, then spoke of a memory even greater.

"We stepped over all the presents and sat down together on the big couch, with Ellie on a pillow on our laps. She was the best present we could get," she said.

"It's kind of changed our Christmas forever."

To reach Mike Lawrence call 871-4203 or e-mail mlawrence@steamboatpilot.com

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