HER TINY HEART

By Jeffrey Kluger

Cheyenne Pyle became famous last week, and the best part is that she'll never remember a bit of it. Early Sunday the 7-lb. 8-oz. girl was born at the University of Miami-Jackson Children's Hospital. Ninety minutes later, she was undergoing surgery to replace her underdeveloped heart, an operation that restored her to health and made her the world's youngest heart recipient.

Even before Cheyenne was delivered, doctors knew she was in for a rough ride. Ultrasound revealed a deformity in the left side of her heart; she would need either a grueling series of procedures to correct the defect or a single operation to replace the organ. Her parents chose the transplant.

Doctors tissue-typed Cheyenne while she was still in the womb, placed her on a heart-transplant waiting list and put a team of surgeons, nurses and transport coordinators on call. Ten days later, during the 36th week of gestation, word arrived that a baby had died during or shortly after birth and the parents had agreed to donate the infant's heart.

The first step in the six-hour operation was a caesarean delivery, during which the frail Cheyenne wailed as lustily as any other newborn. "I wanted her to keep crying so I knew she was alive," says her mother Alberta. Cheyenne soon grew still, however, as doctors lowered her temperature to less than 63[degrees]F to prevent neurological damage during the critical period after her own heart was removed and before her new, golf ball-size heart was in place. Not until the patient reached this state of suspended animation was it safe to make the surgical swap.

Cheyenne's initial prognosis is good: doctors give her an 80% chance of survival. But throughout her entire life she will depend on immunosuppressant drugs to prevent organ rejection. What matters most to her family, however, is that she will have that life.

--By Jeffrey Kluger