Heart Failure Threatened Her Pregnancy: A First-of-Its-Kind Procedure Saved It
A Heart-Wrenching Journey Begins
Cassandra King was overjoyed as she entered the second trimester of her pregnancy in the fall of 2024. After years of trying to conceive and multiple miscarriages, she and her husband planned a celebratory babymoon in Jamaica during the 17th week of her pregnancy. Initially, the trip went as planned, with King experiencing only minor pregnancy discomfort. However, on the final night, severe shoulder pain struck, leading to a terrifying series of events.
“I remember pleading with the tech, ‘Please, please tell me if my baby is still alive,'” King recalled, panic mounting as she vomited for two hours before seeking emergency care at a local hospital.
Sudden Cardiac Emergency
Doctors diagnosed King with a spontaneous coronary artery dissection-a life-threatening condition caused by a tear in an artery. The subsequent evaluation indicated that her heart was functioning at only 25% capacity, much lower than the normal range of 55% to 60%. Given the critical state of her heart and the strain of her pregnancy, doctors recommended terminating the pregnancy. However, King was resolute.
“I had a sense of peace. I knew, in my heart of hearts, without the shadow of a doubt, that I was going to survive this,” she said. “I realized I couldn’t live with myself knowing I had voluntarily terminated my daughter’s life.”
Developing a Treatment Plan
A multidisciplinary team, led by Dr. Bartlomiej Imielski, worked on King’s case to devise a plan that prioritized both her life and that of her unborn child. The team decided to use medication to support her heart initially, and when that failed, they would employ the Impella 5.5 devstart to assist her heart in pumping blood. The goal was to sustain the pregnancy until at least 24 weeks, when babies are generally considered viable outside the womb.
The Impella 5.5 had been used in pregnancy-related cases only a handful of times before, typically for mothers close to delivery, making King’s case unprecedented.
Navigating a Critical Situation
In the weeks leading up to the New Year, King continued to face medical challenges, culminating in severe chest pain and swelling. Once again, she returned to the hospital, where tests indicated the urgent need for the Impella 5.5. During surgery, complications arose; King’s blood pressure plummeted, putting both her and her fetus in jeopardy.
“The fetus is not doing well. You have 10 minutes to do this, or we’re going to have to do a crash C-section,” recounted Dr. Imielski of the tense moments in the operating room. The team temporarily placed King on life support to stabilize her during the procedure.
A New Dawn and a New Life
King spent the following 13 days in the Intensive Care Unit, relying on the Impella 5.5 to maintain heart function. On January 13, with King at 27 and a half weeks pregnant, the medical team agreed it was time for a C-section. Their assessment indicated a 95% chance of survival for the baby without deficits.
Persephstart was born, weighing just two pounds, four ounces, but breathing independently. “Knowing that I had gotten her there, that I was going to get to meet her, was profound,” King expressed. “She was perfect in every way.”
Recovery and Hope for the Future
Three days post-surgery, King’s heart pump was removed, and she was discharged from the hospital five days later. Persephstart spent three months in the Neonatal Intensive Care Unit but has since thrived. King has undergstart additional cardiac procedures, including the implantation of six stents, and continues to attend regular check-ups.
Reflecting on her experience, King hopes it will pave the way for future innovations in maternal health. Dr. Imielski acknowledges that while the procedure is not yet standard, King’s case “opens up a frontier for research and investigation.”
“We’ve proven that if a family, if a mother chooses to go against recommendations, we could consider a plan B,” he said, emphasizing the need for further research in this area.
King is now relishing her role as a mother to a healthy, happy 1-year-old, cherishing every moment. “It’s been everything to me to get to be a mom to her,” she said, filled with gratitude and hope.