Jessica Gottlieb: Congenital Heart Defect

In May 2019, Jessica Gottlieb and her husband Brent were eagerly looking forward to celebrating their fifth wedding anniversary. They’d had more than their share of heartbreak over the years, losing a baby girl on the day of her delivery in December of 2017 and then experiencing another miscarriage in the summer of 2018. Jessica was now pregnant for the third time and they were excited about a baby boy.

Just days before their planned special anniversary dinner, however, the couple was in for a complete shock. They learned that Jessica had developed endocarditis, an infection inside the heart that involves the heart valves. They also learned she had a bicuspsid aortic valve that she never knew about, which is a congenital heart defect where the aortic valve only has two leaflets, instead of three. As a result of the condition and the infection, she had developed severe aortic insufficiency, which is when the aortic valve leaks and causes blood to flow back from the aorta into the left ventricle.

Since Jessica was just 29 weeks along, the initial plan was to keep her in the hospital for six weeks until doctors could safely deliver the baby. However, the results of follow-up lab work 24 hours later quickly caused that plan to change. Doctors told her she was in heart failure and they would need to immediately deliver their baby via C-section so that they could replace Jessica’s bicuspid valve.

 

“I just kept saying to these three doctors at the end of the bed that they didn’t understand … that we could not lose this little baby boy and this was way too early to deliver him,” said Jessica. “Dr. Wagner said, ‘You are the ship and that baby is the passenger, and that ship is sinking and we don’t want it to go down with the passenger on board.’”

Thankfully, Jessica was at Abbott Northwestern Hospital (ANW) under the care of expert doctors on a brand new interdisciplinary Cardiopregnancy Program team with representatives from several partner organizations. The team included Dr. William Wagner from the OB Critical Care Program at ANW and Minneapolis Heart Institute® (MHI) cardiologists Dr. Karol Mudy and Dr. Desmond Jay, who are also researchers at the Minneapolis Heart Institute Foundation® (MHIF). 

First, baby Jack Robert was born via C-section weighing 2 lbs. 10 oz., and measuring 15 inches long. Next, Dr. Mudy performed eight hours of open-heart surgery, replacing Jessica’s aortic valve and repairing the damage the infection had caused to her mitral valve. 

After surgery, Jessica was able to watch baby Jack from the ICU through a webcam and four days after surgery, she was discharged from the ICU and finally able to meet him. After 67 days, Jack finally went home with his parents on his actual due date.

“It wasn’t until my one-month follow-up appointment that I began to realize how serious my condition had been,” said Jessica. “When Brent asked Dr. Mudy, ‘So … you do these kinds of surgeries all the time, right? Dr. Mudy replied, ‘I do surgeries all the time, but not all this complicated and all this serious.’ He also told me I was so lucky because they had just started the Cardiopregnancy Program recently, and that it was just weeks before my surgery that he had been asked to be part of that team.”

In addition to the Cardiopregnancy Program at ANW, researchers at MHIF’s Penny Anderson Women’s Cardiovascular Center are planning various studies in the area of cardiopregnancy, as women face a variety of unique risk factors in pregnancy that increase their risk of cardiovasular disease both in the short and long term. 

“Pregnancy is often said to be nature‘s stress test,” said Dr. Retu Saxena, an MHIF researcher with specific interests related to cardiovascular risk factors that emerge during pregnancy. “In women with cardiovascular disease, pregnancy can often be high risk due to the hemodynamic changes that occur . A collaborative, multidisciplinary approach to the management of these complex high-risk pregnancies leads to an improved outcome for both mother and baby.”

“Today, I’m doing great,” said Jessica, who joined the MHIF team in April 2020 as a major gifts development officer. “Brent and I are both extremely grateful that I happened to be at Abbott Northwestern and under the care of MHI® and are thankful for the research at MHIF that I’m alive and healthy and able to be here to watch my sweet baby boy grow. I’m extremely excited to now be a part of the MHIF team, to share my story, and to share the story of all the amazing work that is happening here.”