What would you do if you found out that you had to have emergency heart surgery while pregnant? For one Wisconsin woman, her life was saved because of the timing. When she went into labor at 39 weeks pregnant, doctors discovered that she had a life-threatening tear in her aorta. As soon as they stabilized her condition, she underwent an emergency C-section and open heart surgery.
Doctors say the woman made history in more than one way. Not only is she believed to be the first pregnant woman in the world with the particular condition, but her case shows that vaginally delivered babies can survive heart surgery shortly after birth.
The unnamed mother was treated by doctors at the University of Wisconsin Hospital and Clinics. They reported her case in the New England Journal of Medicine, noting that she was admitted to the hospital with chest pain and shortness of breath. The results of an internal examination revealed that she had a tear in her descending thoracic aorta.
Surgeons at the University of Wisconsin Hospital repaired her torn aorta through open heart surgery, but they had to perform the complicated procedure during pregnancy due to her condition. Less than 30 minutes after her C-section delivery of her son, surgeons performed an open heart operation on the woman.
Dr. John Deneau, co-author of the case report and director of UW Health’s Vascular Center, says that the patient underwent a rare procedure because of the chance that her baby could’ve suffered during her surgery. We had to get in and out and minimize what we were doing to this new baby, said Deneau.
The doctors recalled: As is typical with any open heart surgery, severe bleeding was encountered through the sternum.Intraoperative transesophageal echocardiography suggested that the infant’s heart was not harmed by the maternal surgery. The neonatal team was activated, and an elective cesarean section was performed at 39 weeks’ gestation.
According to Deneau, if the doctors had waited for a natural delivery, both mother and baby could have died. The way it turned out was a good one because we may have been able to save both.
Past research has shown that babies can survive heart surgery shortly after birth as long as they receive the proper medical attention immediately after. In this case report, the doctors wrote that in order to save both lives, they had to schedule the emergency C-section 36 hours after their patient was admitted. During their operation, surgeons found that one of her coronary arteries was 100 percent blocked.
The woman’s story is believed to be “the first instance of successful maternal open heart surgery followed by immediate neonatal open heart surgery, the doctors wrote.
Her newborn son was awake and crying in the operating room, but he stopped breathing for a moment before the team was able to suction out his airway. After intubation, surgeons performed an arterial switch on the baby’s heart using Gore-Tex tubes. They also repaired two of his heart valves.
The doctors left the newborn’s chest open and performed a video-assisted thoracoscopic debridement of his skin when he was 23 days old. As is typical, after such an extensive operation, the baby spent weeks in intensive care.