The surgery that saved two hearts

Shina is no stranger to complex cardiac operations. Born with a narrowed aortic valve, she had open heart surgery at just 12 weeks old to repair it and restore blood flow. Thanks to regular monitoring into adulthood, she’s been able to live fully and joyfully near Williams Lake, BC.

Shina successfully sailed through her first pregnancy with support from Dr. Marla Kiess and the team at St. Paul’s Hospital’s Complex Obstetrics Clinic, which provides pre-pregnancy counselling and cardiac care to pregnant patients with congenital and acquired heart disease. 

So, when the morning sickness and heart palpitations appeared early in her second pregnancy in 2021, she simply chalked them up to normal symptoms. Then severe leg cramps set in, followed by a spread of red rashes all over her body and a persistent cough. She was so sick she wasn’t able to take care of her toddler.

Following a virtual consultation, Dr. Kiess recommended Shina visit her local emergency department. After seeking urgent care in Williams Lake and Kamloops, doctors discovered she had an infection in her heart valve and was in heart failure. She was airlifted to St. Paul’s Hospital—the provincial centre for complex cardiac and obstetrics cases – for specialized care, leaving her two-year-old son with her mother-in-law while Tyson hurriedly followed south by car.

Cardiac surgeon Dr. Jamil Bashir says that when Shina arrived, her entire valve was “almost liquified”—they had no time to waste. She needed a life-saving open heart surgery to replace the infected aortic valve, but it would put her baby at risk.

“When I heard there was a 40% chance of losing my child, that was devastating,” Shina remembers. She didn’t know if she would survive the surgery or see her firstborn son again. “It was scary.”

Staff at St. Paul’s Hospital were there for Shina every step of the way, providing both physical care and emotional counselling to help her navigate this challenging time. Shina recalls that Dr. Bashir, as well as the ICU nurses, made her feel supported.

“Dr. Bashir was amazing—he was very comforting and positive about everything, which made it easier,” she says. “And we had a lot of people praying for us. The way we had to look at it was: well, if there’s no me, then there’s no baby.”

Staff from numerous specialties, including cardiology, obstetrics, infectious diseases, and anesthesiology, collaborated to plan the intricate surgery required to replace Shina’s valve with a new mechanical one. There were many tricky elements to consider, from choosing the right anesthesia to safely keeping her on the heart-lung bypass machine to tightly controlling her temperature.

After 30 years in the field, Dr. Bashir says that Shina’s surgery was “the most people that I've ever had in the operating room at any one time from different disciplines.”

Shina remembers waking up the next morning in the ICU, where she learned the surgery was a success: “Dr. Bashir showed me on his phone—my baby had a heartbeat and was still kicking in there. That was incredible.”

Dr. Bashir thinks that these kinds of successes are “classic” at St. Paul’s Hospital, due to the expertise, skilled communication, and outpouring of support from different departments. “People work with each other really well here, so we are often able to bring teams together and get great outcomes,” he says.

But Shina still had an infection – as well as several months to go in her pregnancy. Before she headed back to Williams Lake, infectious diseases staff stepped in to ensure she had the right antibiotic treatment at home. She was introduced to obstetrician Dr. Nancy Mitenko, who worked with Dr. Kiess and the Complex Obstetrics Clinic to create a detailed plan for the remainder of the pregnancy and childbirth. As Shina’s new heart valve requires lifelong blood thinners, Dr. Tony Wan and the thrombosis team provided medications that were safe throughout her pregnancy and beyond.

Staff scheduled a C-section delivery for January 2022; but even with the best-laid plans, sometimes babies have their own timeline. On Boxing Day in 2021, Shina began having labour pains. Once again, she was airlifted to St. Paul’s Hospital, leaving with only the clothes on her back. It turned out to be false labour—but staff wanted her to stay in town for monitoring until her planned C-section. Shina had nowhere to stay, and the Complex Obstetrics Clinic staff stepped in with lists of options and gift certificates so she could buy basic necessities.

“There was a lot of support through the hospital to get us set up,” she recalls. 

Merritt was born on January 24, 2022, weighing six pounds, four ounces. Shina is grateful for the expert, attentive, and compassionate care that guided her through surgery, pregnancy, delivery, and postpartum recovery.

“I felt like I had a personal relationship with everyone that dealt with my case,” she says.

That feeling is mutual. Mere steps away from his desk, Dr. Bashir has newborn photos of Merritt on his bulletin board, and Drs. Kiess and Mitenko are delighted that both mom and baby are thriving.

“We all felt wonderful that she made it through this very complex pregnancy: it really highlighted how well our team works,” says Dr. Kiess. “I do not think that the outcome would have been so positive without the assistance of the very experienced, multidisciplinary Cardiac Obstetrics team at St. Paul’s Hospital, who provide this service for the entire province of BC.”

Today, Merritt is a healthy, happy, and chatty three-year-old, with the occasional toddler tantrum thrown in for good measure. Shina says she feels better than ever, and cherishes the precious time she has with her family. 

“I believe that God put these people at St. Paul’s Hospital in my path to help save my life and my son's life,” she says. “We wouldn't have made it through without them, or the prayers and support we received from family and friends.”

When you give to Lights of Hope, you bring compassion to patients and families during their most challenging moments. You help give patients like Shina the opportunity to embrace life with strength, vitality, and joy. And, you help support innovative research that saves and improves lives.

Give now