Mom Gives Birth in Cardiac Operating Room, One Week Before Open Heart Surgery

When Casey Shannon, 29, found out she was pregnant with her second child, she was expecting an uneventful pregnancy, as she had with her first son. She was stunned when doctors told her an artery near her heart was threatening to burst.

She was referred to Cleveland Clinic’s Cardio-Obstetrics Clinic, where she underwent a battery of tests, including genetic testing. Doctors diagnosed Casey with a rare, genetic disorder called Mosaic Turner Syndrome. The condition can lead to heart problems, including an aortic aneurysm.

On January 10, 2019, about 31 weeks into her pregnancy, Casey underwent a cardiac MRI to check on the status of her aortic aneurysm. It’s an abnormal bulge in the wall of the artery that carries blood from the heart to all parts of her body. If the aneurysm were to rupture, it could be deadly for Casey and her unborn son, Felix.

When doctors reviewed the MRI results that day, the news was grim. The aneurysm had grown more than two millimeters larger, a significant increase in size.

“The MRI showed Casey’s aorta was very large and dangerous, and could rupture at any second,” explains maternal fetal medicine specialist Katherine Singh, MD. “For the sake of her and the baby, we had to admit her to the hospital immediately.”

Because the baby was not due for another seven weeks, physicians administered fetal lung maturity steroids to hasten the baby’s development and began planning for an imminent C-section delivery. Casey remained calm as she was admitted to the hospital. Her biggest worry was for her 5-year-old son, Donald, back home in Wooster, Ohio.

“That was probably the hardest part, honestly, because Donald would call and say ‘Couldn't you come home?’” Casey recalls. “And I couldn't. I told him, ‘I’ve just got to make sure baby brother's okay.’”

Given the high risk of the aneurysm rupturing during childbirth, Casey’s Cleveland Clinic medical team decided to schedule her C-section for January 15, 2019. However, they scheduled it in the cardiac operating room instead of a maternity operating room. According to Dr. Singh, “The only time we do a delivery in the cardiac OR is when there's a very high risk for heart, lung, or vascular complications in the mother. It was possible Casey would need emergency surgery with cardiopulmonary support.”

That’s why heart surgeon Gosta Pettersson, MD, PhD, was in the room – as a precautionary measure – when Dr. Singh performed the C-section.  Fortunately, no complications ensued and baby Felix, weighing 4 pounds 8 ounces, was delivered and whisked away to the neonatal intensive care unit (NICU).

“All the cardiac nurses were very excited to see him. They don’t get many babies in there,” says Casey. “They took him right away to the NICU, which is good. But I didn’t get to spend any time with him.” As Casey recovered from her C-section, cardiac nurses accompanied her to the NICU to monitor her heart, as she spent time with Felix.

Exactly one week after delivering Felix, Casey was wheeled into another cardiac operating room to repair her aortic aneurysm.

According to Dr. Pettersson, who performed the surgery, the wait was necessary to ensure Casey had no postoperative issues from the C-section. “There’s always a risk of bleeding after delivery and we wanted to give her a little bit of time to minimize the possibility of any complications.”

The operation went as expected and Casey was able to return home and reunite with Donald after a few days. However, one week later, she became short of breath while reading a story to her son. At her mother’s insistence, she returned to Cleveland Clinic for one final January procedure: treatment of a pulmonary embolism, a blood clot in the lung (not uncommon after childbirth).  She also continued to visit Felix in the NICU, as he grew strong enough to go home.

Finally, seven weeks after Felix was born and almost exactly on his original due date, he too was discharged from the hospital. Casey and her fiancée were able to have their entire family home.

Life has since returned to a chaotic normal for Casey. She’s back at work, Donald started kindergarten, and a healthy Felix just turned 1 year old and is on the verge of walking, “He’s into everything. He just follows in his big brother’s footsteps. He’s perfect.”