Adrian Aguilar Life Saving PDA Surgery to Close a Congenital Heart Defect

Baby Adrian sleeping Already parents to a 10-year-old son and two daughters, ages 8 and 6, Cinthia and her fiancé, Adrian, hoped to welcome another child and complete their family.

Shortly after stopping birth control, Cinthia learned she was pregnant. She and Adrian were overjoyed.

Because of her history of preeclampsia, a serious pregnancy complication characterized by high blood pressure, Cinthia's OB-GYN referred her to a maternal-fetal medicine specialist for additional monitoring throughout her pregnancy.

“My first visit with my MFM didn’t go very well,” said Cinthia. “At 24-weeks, my sugar levels were high. I had to take insulin to control my blood sugar. My blood pressure was fine, but my doctor wanted me to monitor my blood pressure regularly. During that visit, I found out our son had a single umbilical artery in his umbilical cord.”

A typical umbilical cord contains two arteries and one vein. The vein carries oxygen and nutrients to the baby, while the arteries remove waste products. A single umbilical artery occurs when one of the arteries is missing. Although many babies with a single umbilical artery are born healthy, the condition can sometimes affect growth or be associated with other developmental concerns.

To further evaluate the baby's heart development, Cinthia was referred for a fetal cardiology evaluation. Multiple echocardiograms showed that her baby's heart was developing normally, providing reassurance as the pregnancy progressed.

“When I was 33 weeks pregnant, I began having pain and my blood pressure was extremely elevated,” said Cinthia. “My BP was over 200 and they could not get it down. So, I needed an emergency C-section.”

Cinthia and Adrian welcomed their son, Adrian, on Aug. 10, 2022, at a San Antonio hospital. Despite the unexpected challenges leading up to his birth, they were excited to finally meet their newborn son.

“Our son was small and weighed three pounds,” said Cinthia. “After Adrian was born, he was taken to the NICU and put on oxygen right away. He did well and then he began breathing unusually fast. His tummy would go up and down super fast. He could not bottle feed because of his breathing. It took a lot of effort for him to eat, and his nurses didn’t want him to overdo it. So, he was fed through a NG tube."

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Two Unexpected Diagnoses

After undergoing several diagnostic tests, including heart ultrasounds and a brain MRI, Cinthia learned her son had tuberous sclerosis complex, a rare genetic disorder that causes benign tumors to form in the brain and other organs potentially leading to a range of health and developmental challenges. Adrian was also diagnosed with patent ductus arteriosus (PDA), a heart condition in which an opening between two major blood vessels fails to close after birth. When the PDA remains open, it can cause excess blood flow to the lungs and place additional strain on the heart.

“The cardiologist gave my son Motrin for three days but that didn’t close his PDA,” said Cinthia. “Since the hospital didn’t have a (pediatric) cardiovascular surgeon nor a cardiologist that could close Adrian’s PDA, our son was transferred to CHRISTUS Children's. His doctors wanted him to have access to all of the specialists that he needed in one place.

”On September 2, 2022, at three weeks old, Adrian was transferred to CHRISTUS Children's.

Adrian’s Life-Saving Care

Upon arriving at CHRISTUS Children's, Adrian was evaluated by the pediatric heart team and specialists who worked together to determine the safest and most effective treatment plan for his complex medical needs.

The initial plan was to perform a transcatheter PDA occlusion, a minimally invasive procedure used to close the ductus arteriosus without open surgery. During the procedure, a catheter is inserted through a blood vessel and guided to the heart. Using imaging technology and contrast dye, the care team can visualize blood flow and position a closure device to seal the PDA.

On Sept. 8, Adrian underwent the procedure. During the evaluation, imaging revealed that his PDA was too large and too short for available closure devices to be safely implanted. After carefully assessing multiple options, the care team determined that the procedure could not be completed safely. Adrian was returned to the NICU, where he continued to receive specialized care while a new treatment plan was developed.

Because the PDA could not be closed using a catheter-based approach, Adrian would need heart surgery to repair the defect.

“I broke down and cried,” said Cinthia. “When you hear heart surgery, you think the worst. He was such a tiny fragile baby; how could he undergo heart surgery? It was hard to see my baby have to go through this. I was scared.”

Adrian’s PDA surgery

Cinthia and her fiancé met with Dr. Victor Bautista-Hernandez, a cardiothoracic surgeon, who explained the procedure that would be used to close their son's PDA.

The following day, Dr. Bautista-Hernandez performed a PDA ligation at Adrian's bedside. Rather than opening the breastbone, the procedure was performed through a small incision beneath Adrian's arm, allowing the PDA to be safely identified and closed.

“Dr. Bautista told me he wouldn’t have to open up my son’s breast bone,” said Cinthia. “Instead, he made an incision in the area underneath my son’s armpit. He was able to see the PDA through the tiny incision and closed it with a suture. Immediately after the procedure, my son’s breathing improved significantly.”

While Cinthia and her fiancé were relieved that the surgery was successful, it was difficult watching their son recover. After spending an additional 17 days in the NICU, Adrian was finally ready to go home.

Adrian Today

Today, Adrian is a healthy and thriving child. He continues to grow, stay active and eat well. He also loves being the center of attention, and his older siblings adore their little brother.

“I am amazed by Adrian’s progress,” said Cinthia. “Our family is thankful we were sent to The Children’s Hospital of San Antonio where our son received the life-saving surgery he needed. The doctors were amazing and took the time to explain everything to us. They were invested in my son’s outcome and wanted the very best for him. They helped calm our fears. The NICU nurses were great. They were always there when we needed them. They took great care of Adrian. They were on top of everything."

As part of his ongoing care, Adrian sees his pediatric cardiologist to ensure his heart continues to function normally. He also follows up regularly with his pediatric neurologist, Dr. Jose Aceves, for monitoring of his tuberous sclerosis complex. While Adrian has a few benign tumors, he has not experienced seizures. Dr. Aceves continues to monitor his condition and development through regular follow-up visits.

To learn more about the Interventional Cardiology Program at CHRISTUS Children's, visit Pediatric Cardiology & Heart Care | CHRISTUS Health.

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