Team effort helps pregnant Augusta mom, baby survive rare aortic valve replacement

ATLANTA - When Lindsey Turman's daughter Adiya was born January 27, the 31-year-old felt like she could finally catch her breath.

"I cried and cried and cried, and I was just so thankful that the Lord had brought all of us through all that," Turman remembers.

Months earlier, Turman and her husband Tevin, had come to the Piedmont Heart Institute from Augusta, after learning an aortic valve surgeons had replaced in 2017, which had held through her first pregnancy with their daughter Eliana, was now narrowed and failing.

Interventional cardiologist Dr. Pradeep Yadav says the valve posed a risk not only to Turman's life, but to her baby's.

"I was very, very scared," Turman says.  "I was sad."

Turman's heart surgeon had sent her to see Piedmont cardiothoracic surgeon Dr. Vinod Thourani.

"The question of how to deal with this is unbelievably complicated," Thourani says.

Dr. Yadav says they needed a plan.

"Both their lives were in jeopardy if you don't fix the valve before delivery," he says.

So, Thourani and Yadav pulled together a room full of specialists to figure out what to do.

"From the OB team, the first question was, 'Why don't we do a c-section and take the baby out, and then you can deal with the valve,'" Yadav says.  "The problem with that scenario was the moment you give anesthesia, there was a 50/50 chance that her heart rate would slow down and her blood pressure would drop."

That could be deadly.

Another option was to deliver the baby prematurely, but the team was not sure Turman's aortic valve could hold through the delivery.

So, they chose to go with a transcatheter aortic valve replacement, or TAVR procedure.

"The plan was to get me to 32 weeks," Turman says.  "That way, in case something happened, the baby could come out, and she'd be preterm and go into NICU, but she still had a pretty good chance of survival."

Dr. Thourani says he's performed at least 3,000 TAVR procedures.

But performing the procedure on a pregnant woman required incredibly teamwork.  

"The important part was not the actual procedure, because that's a relatively routine procedure now," Thourani says.  "What was the most important part was making the decision of which way to do it and getting OB-GYNs, cardiologists, imagers, interventional cardiologists, cardiac surgeons sitting in one room together and making that decision of what to do."

Dr. Yadav says they tried to think of every possible complication.

"We drew several scenarios, like, 'What if this were to happen, how are we going to act, and in what sequence," he says.  "Because, if an emergency were to happen, there was no time to think about it."

Lindsey Turman made it to 35-weeks.

On January 6, Thourani and Yadav worked together, surrounded by 15-20 specialists.

"They had the OB, the heart surgeon, the anesthesiologist, the TAVR surgeon, and they all had their team to help them," Turman says.

Turman never had to go under general anesthesia.

The team, carefully shielding the baby from radiation, threaded a catheter, or a long thin tube, from Turman's groin up to her heart.

"Through that tube, we can advance a brand-new valve all the way to the heart," Dr. Yadav says.  "And, once we're in that position, we can pop that valve open.  The valve starts working right away."

The procedure went off without a hitch. 

Two weeks later, at Piedmont Hospital, Adiya was delivered by caesarian section.  

"I remember just hearing her cry, immediately, and then they bring her to me, and just being so thankful," Turman says.  "It was, like, 'You're here!'  She's such a fighter."

Their long harrowing journey was over.

"I was just so thankful to hold her and say, 'You did it little girl,'" Turman says.

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