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Girl born prematurely making big strides after complex surgery to fix heart valve
Ava Neumann faced a world of challenges after her premature birth in 2002.
At 3 pounds, 3 ounces, she was diagnosed with a serious aortic valve disorder by Dubuque, Iowa, pediatrician Julie Hanson, MD. At age two days, Ava was transferred to University of Iowa Children's Hospital, located at University of Iowa Hospitals and Clinics.
"We were terribly worried they might have to do open heart surgery," says Ava's mother, Peggy Neumann.
Fortunately, Ava did not require surgery immediately. By age 18 months, however, her aortic valve was significantly narrowed with leakage.
A team of pediatric UI Heart and Vascular Center specialists performed a balloon catheterization procedure as a non-invasive first attempt to fix the valve in a conservative way. Unfortunately, the procedure did not work and the leak worsened.
"Her growth rate was greatly slowed, she wasn't getting any stronger, and heart surgery was our only option," Neumann says. "It was a chance we had to take."
Based on a thorough evaluation by the pediatric heart surgery team, Ava was thought to be an excellent candidate for the Ross Procedure, a complex open heart operation in which the defective aortic valve is removed and replaced by the patient's own pulmonary valve. A donated cadaver valve takes the place of the pulmonary valve.
Although technically demanding, the Ross Procedure offers some advantages over traditional surgery. If a mechanical valve is used to replace the aortic valve, for instance, blood thinners are needed for life. Mechanical valves are a site for infection and do not grow as the child grows.
With the Ross procedure, blood thinners are not needed and the new valve can potentially grow as the child grows.
The six-hour procedure, performed Feb.16, 2006, went exactly as planned, giving Ava renewed vitality and a chance to thrive. In fact, she may be medication-free before the end of this year.
Better yet, while Ava might never quite catch up with her twin sister, Annika (who was healthy at birth), she is growing and now weighs about 28 pounds.
University of Iowa Children's Hospital pediatric cardiologist Jill Morriss, MD, says doctors are very encouraged by Ava's progress. "It's very rewarding to know that the options we have for treating children with severe aortic valve disease continue to improve," she says. "Ava has a much better outlook with this operation."
Neumann says her now 4-year-old daughter's ordeal has been a profound and moving experience. "She's my hero. She is a very fast runner, very vibrant and active. We asked some tough questions along the way but we're very happy with the care she received!"
For more information about the pediatric heart care services at University of Iowa Children's Hospital, patients and families should:
For consultation or referral, physicians should contact UI Consult.
—Michael Sondergard
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