Heart surgery

British Columbia woman undergoes open heart surgery while 15 weeks pregnant

Shina Biblow was expecting her second child last year when she started feeling unwell.

“My heart was pounding,” the BC woman said, and also recalled developing itchy red spots on her skin. “Then towards the end of July, beginning of August, I started having trouble sleeping and breathing.”

Biblow, who lives outside Williams Lake in the central interior, said her stepmother drove her to the hospital on August 12.

“That was the last time I saw my son until September 2,” she said. “It was very emotional and scary.”

The urgency of Biblow’s situation led her to be airlifted to Kamloops and then to St. Paul’s Hospital in Vancouver.

Bilow already had a connection to St. Paul’s. She was born with a stenosis of the aortic valve and underwent surgery as a child. After being followed by BC Children’s Hospital for years, she then became a member of the Pacific Adult Congenital Heart Clinic in St. Paul’s as an adult.

Cardiologist Dr Marla Kiess said it became clear Biblow had a heart infection.

“She had a very aggressive infection,” Kiess said. “Basically, his aortic valve was destroyed and wasn’t working at all. It leaked very badly and she had heart failure.

Biblow said it was quickly decided that she would undergo open-heart surgery: a complex procedure that also posed a risk to her pregnancy, which was then 15 weeks long.

“We didn’t know what the outcome would be, but it had to be done,” she said. “Without me, there was no baby, so it was our only option.”

Kiess said Biblow’s aortic valve needed to be replaced, necessitating the use of a cardiopulmonary bypass machine during the operation.

“This machine doesn’t produce normal blood pressure, and in a way, on purpose, we’re trying to hibernate the body,” she said. “But it could also have a negative effect on the fetus, which of course depends on the mother’s blood supply.”

Kiess said the mortality of a fetus at this stage of pregnancy on cardiopulmonary bypass “is high.”

“We had to prepare her for the fact that the fetus could die during the operation,” she said. “She was really sick before going to surgery, and we were very worried that she wouldn’t even be able to make it to surgery.”

The three to four hour procedure replaced the Biblow valve with a mechanical valve. Kiess said there is also an option for a bio-prosthetic valve from an animal, but added that there are pros and cons with each choice.

“With a mechanical valve, it’s usually one surgery in your lifetime. It lasts forever, but you have to take blood thinners because the valves tend to clot,” she said. “Or you can choose what we call a bio-prosthetic valve, or a valve from an animal, but then you’re going to be looking at another surgery in 10 years.”

Kiess said the hospital only performs open-heart surgery on pregnant women “once or twice a year.”

“There’s a huge team of people involved in caring for a complex patient like this,” she said. “We had several meetings with people to come up with the best possible plan.”

With a team of specialists, doctors and nurses on hand, Biblow’s surgery last August was a success.

Bilow said she is grateful for the care she received.

“They were awesome…every nurse we had was just amazing and so attentive, all the doctors were amazing and they worked together so quickly,” she said. “Very scary situation and they made it a lot easier for sure, and we’re very grateful for that.”

In January, the 32-year-old returned to St. Paul’s to give birth to her second son, Merritt. They are now back home with her husband and Merritt’s older brother Morris, two and a half.

“We’re so happy to be home,” Biblow said. “It’s a bit like a second chance in life. You look at life differently and appreciate things a lot more, that’s for sure…it’s just an amazing feeling.