With Prenatal Imaging, Starting Early to Save a Child’s Heart

Kaylie thought her pregnancy had been perfectly normal. Then she went in for her standard second-trimester morphology scan. This test is designed to show the health of the placenta, umbilical cord, and amniotic fluid. Kaylie’s scan, though, indicated that her fetus might have a heart condition.  

To get a more precise diagnosis, Kaylie and her husband, John, went to the Fetal Heart Program at the Mount Sinai Kravis Children’s Heart Center. They saw Kenan Stern, MD, Assistant Professor of Pediatrics and Radiology at the Icahn School of Medicine at Mount Sinai.

To get a better picture of what was going on, Dr. Stern performed an ultrasound of the fetal heart. It became clear that the fetus had pulmonary valve stenosis, which is a thickened or fused heart valve that doesn’t open all the way. Because the blood can’t flow easily through the valve, the heart’s ventricle has to pump harder than usual to force the blood out. This extra pushing increases the pressure on the ventricle wall, which makes it grow thicker. Pulmonary valve stenosis can, if left untreated, lead to low oxygen levels, heart stiffening and possible heart failure.

Kaylie and John met with Dr. Stern and Robert H. Pass, MD, Professor of Pediatrics and Chief of Pediatric Cardiology at the Icahn School of Medicine at Mount Sinai, Co-Director of Mount Sinai Kravis Children’s Heart Center, and Director of Pediatric Electrophysiology, Mount Sinai Health System, to discuss treatment options. They were particularly concerned because John had experienced the same condition as a child. John needed open-heart surgery at 15 months of age, and he and Kaylie wanted to avoid that for their little one. It turned out that John’s cardiologist was a friend of Dr. Pass, and John brought in an old-handwritten note from her that summarized his condition.

The doctors assured Kaylie and John that a prenatal diagnosis allowed them to plan ahead and have the team prepared for any intervention. Kaylie would need to give birth at The Mount Sinai Hospital. Her obstetrician was Heather E.A. Hume, MD, who has special expertise in helping patients with prenatal problems. 
Four weeks before Kaylie’s due date, her regular prenatal exam showed that her amniotic fluid was too low. She was admitted to hospital for observation—and had a cesarean section the next day, giving birth to Sofia on September 11, 2019. 

Two days later, Dr. Pass performed a successful balloon catheterization to open up Sofia’s pulmonary valve, and the baby then spent a week in the Neonatal Intensive Care Unit for observation.

These days, Sofia is a happy 16-month-old. She has not required any re-interventions. Kaylie and John are relieved. “We have so much gratitude to all the Mount Sinai medical staff,” says Kaylie, “especially the Children’s Heart Center for saving our daughter’s life!