Support: Noah, 5, and mum Leanne share a cuddle out of bed two days after his open heart surgery. Picture: Cameron Tandy

By: Grant McArthur

"EVERYTHING went very well . . . his heart has tolerated the surgery very well . . . there is no problem at all." With tears of joy and relief streaming down their cheeks, these were the words Leanne and Steve Amarant had waited more than five years to hear.

Although they had tried to put thoughts about their son's impending surgery at the back of their minds, the Stawell parents had simultaneously dreaded and looked forward to last Friday, the day their son Noah underwent complex open heart surgery.
After operating for seven hours on their son, Royal Children's Hospital director of cardiac surgery Dr Christian Brizard emerged to tell them the operation had been a success and five-year-old Noah's quality and length of life should dramatically improve.

"It went very smoothly -- not a glitch," he said. "It took a while. We had to dissect (through scar tissue) for about two hours, but we are very happy with how it went."

On the way: Noah is anaesthetised using chocolate flavoured gas before his marathon surgery

The operation was the third and final stage of a process which began hours after Noah's birth on November 14, 2001, when he was diagnosed with hypoplastic left-heart syndrome, a condition that prevented the left side of his heart developing.

Within five days of his birth, Noah underwent the first stage of the process, designed to keep him alive in the short term.

At three months his chest was opened again so the second stage could direct blood around the top half of his body, through his lungs and back to his heart.

After five years to allow his body to develop, Friday's procedure was the final stage of the Fontan operation, in which blood from the lower half of Noah's body is redirected to pass through his lungs and back to his half-heart to simulate as closely as possible the function of a normal heart.

In the first few weeks of Noah's life, Dr Brizard and others took the Amarants aside on three occasions to tell them their son would probably not survive until the next morning.

But moments after seeing their son come out of the operating theatre for the 16th time, the relieved parents said the process didn't get any easier.

"You love them when they are born, but losing him now is even more unthinkable than it was earlier," Mrs Amarant said.

Concentration: Dr Brizard during the seven-hour surgery

"When they said it (the operation) was going to be a few years, it seemed such a long way away, so you put it out of your mind for a while. But we've had a good 12 months waiting and wondering when they were going to do it, and it has had a big build-up, so it is nice to be on the other side of it."

The surgery was nearly postponed because of Noah's soaring temperature; but by 7 the next morning his spirits had soared.

As he relaxed, playing video games minutes before being anaesthetised, the only frayed nerves were his parents'.

"This morning was terrifying -- and the last few days have been pretty terrifying," Mrs Amarant said. "I don't know how to describe the feeling when you hand your child over, but I have been to the point of throwing up. It's just that helplessness of being the parent."

In the theatre, a team led by French surgeon Dr Brizard had difficulty getting to Noah's heart through layers of scar tissue caused by so many operations.

By 11am, he was placed on bypass and Dr Brizard began attaching an 8cm gortex tube beside his heart to redirect blood flow.

At 3pm, Noah was wheeled out of theatre and into the pediatric intensive care unit, where he is so well known his photos hang on the walls.

By Saturday morning Noah was pleading with his parents to go home. While that will not happen for weeks, his parents hope it will be years before their son has to undergo major surgery again -- if at all. "We are extraordinarily lucky . . . Lots of people with kids with this condition don't get to take them out of this place except to bury them," Mrs Amarant said.

In recovery: Noah relaxed in bed, just two days after his surgery