Ava’s storyComplex surgery for a complex heart

Photos by Jamie Rhodes, Norton Healthcare. © 2016

How the Heart Center repaired a toddler’s heart and vital structures

At age 1, Ava Delaney was living in an orphanage in China. You wouldn’t know it to look at her, but she had life-threatening heart and organ defects. Ava was placed on a website for adoption of children with special needs. The Delaney family from Hardyville, Ky., adopted Ava and found themselves in Louisville at the children’s hospital.

Ava has severe heterotaxy, which means her organs are not on the correct side of the body.

Several very complex heart defects included dextrocardia, in which her heart points to the right instead of the left.

She also has an incorrectly developed pulmonary valve and artery. All of these very serious issues affected Ava’s ability to circulate and oxygenate blood throughout her body.

To repair Ava’s heart would take a day-long surgery (actually, four surgeries in one) performed by specialists in the Heart Center.

On April 27, 2016, Ava’s mom, Catherine, prepared for the long day ahead — a day that would hopefully bring relief to her daughter.

Ava is curious about the things around her and loves name badges.

Pediatric anesthesiologist Steve Auden, M.D., explains what he would do and reassures Catherine just before the surgery.

Finally, it’s time to go to the surgery suites. “The lord gives you strength when you need it,” said mom, Catherine.

The Heart Center operating room team has everything ready for Ava’s difficult surgery, including a large number of clamps that the surgeon would use.

Of course Ava would also need blood and plasma to help her body through the ordeal.

Ava arrives in the operating room, and IV lines are inserted so the team could deliver medication during the procedure. Last-minute lab work also is done.

Now that Ava is asleep, Dr. Auden places a central line, which is used to quickly give medications that affect the heart, take blood samples and give other necessary fluids.

Frank Pigula, M.D., chief of cardiovascular surgery, gets ready to begin.

After a last-minute review of the plan, it is time to start.

Dr. Pigula came to our children’s hospital and University of Louisville Physicians from Children’s Hospital of Boston, where he was the clinical director of the pediatric cardiac surgery program, rated No. 1 in cardiology and heart surgery by U.S. News & World Report. Dr. Pigula also was an associate professor of surgery at Harvard University School of Medicine.

The team works through the day. Procedures included a TAPVR repair, a hemi-mustard, a repair of Ava’s complete AV canal defect and repair of the pulmonary arteries. In other words, they repair her heart.

“We’re doing some things here that we haven’t done before,” said Dr. Pigula, who is also co-director of the Heart Center. “I feel honored I was able to contribute and help Ava.”

“I don’t look at it as just a hospital,” said mom, Catherine. “I feel like it’s family. I’m amazed at everything that was done for our daughter.”

“I hope Ava can be an inspiration for other families whose children need heart surgery.”

- Catherine Delaney