HealthLeader

An Online Wellness Magazine produced by The University of Texas Health Science Center at Houston (UTHealth)

Out of Options

Expectant mother finds life through innovative heart procedure

When Cecilia Figueroa decided in early 2017 that she wanted to have a child, she had to be more careful than most. A perilous medical history included six years of dialysis, a kidney transplant, and a transplanted aortic valve in her heart — the original valve a casualty of high calcium caused by her kidney troubles.

After getting approval from her kidney doctors, she needed an echocardiogram to ensure her new heart valve could handle a pregnancy. 

“So I went to my cardiologist at the time, and he told me the test came back good,” she says. 

A month later, Cecilia — now pregnant — suddenly felt sick. She suspected from previous experience that it involved her heart, so she returned to her cardiologist for another test. According to Cecilia, the doctor admitted that the first test he ran before she was pregnant showed severe damage to her aortic valve, but he withheld the results because he didn’t want to worry her. Her only option, he said, was to terminate her pregnancy and then undergo open-heart surgery to replace the valve. 

“It was really upsetting because what right did he have not to tell me the first time?” Cecilia says. “If I had known, I would have taken care of the problem before getting pregnant.” 

For Cecilia, following the doctor’s new advice was unthinkable — so she turned to The University of Texas Health Science Center at Houston (UTHealth). 

“Even if I terminated and had the surgery to save my life, who’s to tell me that I wouldn’t have died during surgery? I’m not God,” she says. “If I was going to die, I was going to die trying to let my son have a chance to live.”

Cecilia consulted with cardiologist after cardiologist, and all confirmed her first doctor’s prognosis. But one suggested she seek out Richard Smalling, M.D., Ph.D., James D. Woods Distinguished Chair in Cardiovascular Medicine in the Department of Internal Medicine and director of interventional cardiovascular medicine at McGovern Medical School at UTHealth and Memorial Hermann Heart & Vascular Institute-Texas Medical Center. Smalling suggested a new minimally invasive procedure known as transcatheter aortic valve replacement (TAVR). Instead of open-heart surgery, he would thread a new aortic valve to her heart through a catheter. 

“Open-heart surgery would have been prohibitively risky for her unborn child and high-risk for her as well,” Smalling says. “After evaluating her and discussing her case with our surgical colleagues, we felt TAVR would be the best option to help her through the pregnancy and allow her to have her son safely.”

Everyone involved would be sailing uncharted waters: no doctor had ever attempted the procedure on a pregnant woman with a transplanted kidney and a transplanted, severely damaged aortic valve. 

“But he said he was willing to try if I was willing to try,” Cecilia explains. 

On July 6, Smalling and his team performed the TAVR procedure on Cecilia. She left the hospital two days later without any further problems. Her son Sebastian entered the world on November 9, completely healthy. 

Cecilia looks back on her perseverance — refusing to accept the answers her doctors gave her until she found a different one — and finds the importance of never giving up. She also remembers
the exceptional boldness of a doctor and his team who will always have a special place in her heart. 

“We are really thankful to God for Dr. Smalling and all his team,” she says. “He gave us the hope that nobody did.”

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