Facing the Unthinkable: Heart Surgery for 4-Year-Old

When Lauren and Thomas Bolick headed to the hospital in 2020 to have their second child delivered, the looming presence of COVID-19 should have been the worst thing they had to worry about. But fate had other plans.

They had a single day to spend with their newborn son Ashton before a doctor came into their room at Orlando Health Winnie Palmer Hospital for Women and Children to tell them they had heard a murmur in his tiny heart – enough to warrant an echocardiogram.

“Once the echo was done, that’s kind of when our world shifted,” Lauren says.

Ashton had been born with congenital heart issues. Some, like his right aortic arch, could be relatively benign. But there was also an atrial and ventricular septal defect, and these were cause for concern. They were actual holes in Ashton’s heart.

The good news was that they weren’t immediately life-threatening. In fact, some people with the same condition might go their entire life undiagnosed. The bad news was that all the Bolicks could do was endure an unthinkable waiting game and see if Ashton’s heart would heal over time.

“As far as what the game plan was, it was really just wait and see,” Thomas says. The holes could close on their own; they might not.”

Playing the Waiting Game with Baby’s Heart Condition

For a time, it seemed like waiting was all the family could do. Regular visits to a cardiologist showed that the holes were in fact shrinking. In between those visits, Ashton crawled, walked, then ran to keep up with his older brother Charley at the Bolicks’ Apopka home.

“He ran, played, laughed and never showed any obvious difficulty breathing or swallowing,” Thomas says. “Every time we went in, we started to let our guard down a little.”

He ran, played, laughed and never showed any obvious difficulty breathing or swallowing. Every time we went in, we started to let our guard down a little.— Thomas Bolick, Ashton’s dad

A few months before Ashton’s fourth birthday in June 2024, his parents took him in for yet another routine checkup. It turned out to be anything but.

An echocardiogram showed that while Ashton’s septal defects were in fact healing, the one in the bottom half of his heart, between the two pumping chambers, was doing so in a way that upset his hemodynamic – the delicate balance of blood flow between the chambers.

“Think of a garden hose, and how you put your thumb on it,” Thomas explains. “It sprays out.”

While Ashton might not feel any effects in the short term, this jet of blood would lead to a thickening of muscle in the lower chambers. The likely result: Arrythmia and heart failure later in life. A panel of Orlando Health cardiologists and cardiac surgeons evaluated the scans and gave the Bolicks news that sent them into a daze all over again. Ashton would need to undergo heart surgery.

Choosing Heart Surgery for Ashton

For Ashton’s mom, the news was a chilling flashback to the first fragile days of her son’s birth. Ultimately, the decision was in the hands of his parents.

“We asked all the questions,” she recalls. “He’s a small child. Wouldn’t it be better for him to be older?”

The one to set their minds at ease was Dr. T-Y Hsia, the Chief of Pediatric and Congenital Heart Surgery at Orlando Health Children’s Arnold Palmer Hospital. He explained that not only were the staff well-qualified to perform the procedure, but the overall risk is low and recovery time short in their comprehensive pediatric heart unit. Like Ashton, approximately five out of 1,000 babies are born with a heart condition that requires surgery, but Dr. Hsia and his team specialized in treating those that did.

“A 4-year old patient is actually a relatively older and bigger patient to undergo open heart surgery,” says Dr. Hsia. “We typically operate on newborn babies and infants. Our patients are usually 5 pounds, 6 pounds.”

Dr. Hsia put the Bolicks at ease.

“Dr. Hsia never rushed us,” Lauren says. “He patiently answered our endless questions, walked us through every detail, and gave us the reassurance we desperately needed during such an uncertain and frightening time.”

The Fast Lane To Recovery After Pediatric Heart Surgery

With their son’s future firmly in mind, the Bolicks admitted their boy into Arnold Palmer in September 2024. For Ashton, the surgery happened between the blinks of an eye. For his parents, the waiting was excruciating. But the staff did their best to make the experience a smooth one for all three.

“[Ashton] was originally going to take one of Arnold Palmer’s electric toy trucks to the OR, but he got a little nervous so they decided to sedate him a little bit,” Thomas says. “So we said our goodbyes and they took him back on a bed. Then he woke up, and that was one of the first things he asked: ‘I never got to ride the jeep!’ Within the first 24 hours, they brought the jeep up for him to ride around inside the ICU, which I thought was really neat.”

During the surgery, Dr. Hsia and his team closed the holes in Ashton’s heart and repaired his aortic arch for good measure. And true to the doctor’s predictions, his young patient did indeed bounce back quickly.

“We went in a Tuesday and were home by Friday,” says Lauren. “And he was back to his normal self like honestly, two days later.”

An Orlando Health Team United in Care

Today, Lauren and Thomas can’t say for sure if their son even remembers the surgery. But he definitely remembers where he spent those days in recovery.

“[He refers to Arnold Palmer] as ‘his hospital.’ He always talks about Seacrest Studios (the facility’s interactive media center) and the castle that’s there,” Thomas says. “And the train for sure. He always remembers the train.”

Dr. Hsia remembers his patient, too.

“What I tell parents is look, I actually wish that no one needs my services. I wish my profession did not exist. Who wants their child to have open heart surgery? But the fact is, I went through decades of education and training and practice to do what I do because patients like Ashton are born with heart conditions that need my expertise,” he says.

Dr. Hsia doesn’t take what he does lightly.

“Every surgery we do, whether it’s something fairly straightforward like Ashton’s to something that’s much more complicated with higher risks, we treat each and every patient and operation with greatest respect and care because we are trusted with someone’s child.”