Home is Where the Heart Care Is



When 4-year-old Kylie Brew visits the doctor, her biggest worry is that she won’t walk away with the small package of Teddy Grahams patients at Sanford Downtown Children’s Clinic in Bismarck customarily receive.

Her parents, of course, have greater concerns, but one thing they don’t have to fret over is lengthy travel for Kylie to receive her routine specialty care.

A little more than a year ago, an echocardiogram, a test that produces an image of the heart, revealed a hole between the lower chambers of Kylie’s heart, which caused the heart murmur she had since birth.

“It was definitely surprising because we had no idea,” said Lisa Brew, Kylie’s mother. “We thought it was a typical heart murmur.”

The condition, known as a ventricular septal defect (VSD), was present in Kylie from birth. Congenital heart defects, such as VSD, are present in around 1 percent of children, said Justin Horner, MD, a Sanford Health pediatric cardiologist.

Because of the VSD, Kylie must undergo routine testing to ensure her heart function remains normal and that the hole hasn’t worsened or caused any damage to the valves in her heart. Rather than travel out of town for those tests, the Brews, who live in Mandan, are able to keep Kylie close to home because of Dr. Horner, who makes regular visits to Bismarck from his Fargo office.

When Dr. Horner is in Bismarck, he conducts a follow-up echocardiogram, other tests as needed and performs an exam. In between visits with Dr. Horner, Kylie’s Sanford pediatrician in Bismarck, Parag Kumar, MD, can consult with Dr. Horner if needed.

“It’s a big benefit. Parents don’t have to travel, and we have a quick opinion to us right away,” Dr. Kumar said. “Our mission is to deliver the best possible care under one roof, and this allows us to do that.”

In one of the first visits with Dr. Horner, Lisa mentioned she is expecting another child. Because Kylie has a congenital heart defect, the chances of the baby having one doubles, Dr. Horner said. So, Dr. Horner performed a fetal echocardiogram on Lisa to check the fetus’ heart to make sure it was developing properly.

“Any time you’re pregnant, you have concerns and worries,” Lisa said. “It gives me peace of mind.”

At some point in the future, Kylie may have to undergo open heart surgery to repair the hole in her heart, a decision the Brews will make while working with Dr. Horner. With or without surgery, Dr. Horner said Kylie likely can expect to live a normal and healthy life with no limitations on her activity, which is welcome news to her parents.

“Kylie would be the last child you’d think would have a heart defect. She is the wild child,” Lisa said. “She’s in gymnastics, and she wants to play hockey. She’s very active, and she would not be a good child to sit on the sidelines.”

With his regular visits, Dr. Horner will make sure Kylie doesn’t have to. Dr. Horner, a Mandan native and graduate of Mandan High, is happy to bring the service to the region.

“We don’t just see people from Bismarck-Mandan,” he said. “We see people from all over the western part of North Dakota, keeping patients closer to home.”

For more information on Sanford Children’s services in Bismarck, visit bismarck.sanfordhealth.org/kids.

Posted Date: September 2013

Home is Where the Heart Care Is

Kylie Brew’s parents are happy they can keep the 4-year-old close to her Mandan home for routine care for her congenital heart defect. She sees pediatric cardiologist Justin Horner, MD, at Sanford Children’s Downtown Clinic in Bismarck.