Baby born during emergency open-heart surgery: First recorded case of its kind in Canada

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At four pounds, onen ounce, Miracle Astra Alice Alfreda Follett is a little tyke with an extraordinary name – fitting for a child whose birth made medical history at Capital Health in Edmonton.

Her first name is Miracle, but her parents are calling her by her middle name—Astra—which means “star.” Also fitting, since Astra became an instant celebrity when her birth made headlines across Canada.

The incredible story began on January 24, 2008 when Astra’s mother, Roxanne Follett—then 35 weeks pregnant – became dangerously short of breath. She was airlifted from Grande Prairie to Capital Health’s Royal Alexandra Hospital’s high risk obstetrical unit where, via CT scan, doctors discovered a life-threatening rupture of Roxanne’s aorta (the largest blood vessel in the body). There was a 40 per cent risk that Roxanne would die within 48 hours without surgery. She needed immediate open-heart surgery to repair the aorta and was rushed to Capital Health’s University of Alberta Hospital’s (UAH) cardiac operating room.

“To further complicate matters, we had not one but two patients,” says cardiothoracic surgeon Dr. Rod MacArthur. “To perform the open-heart surgery would require that Roxanne’s body temperature be lowered to 18 degrees Celcius. It would mean her heart would stop—and so would her unborn baby’s heart.”

What happened next was an extraordinary effort across Capital Health that would save two lives. An obstetrical team from the Royal Alex joined the cardiac team at the UAH to deliver the baby immediately. First, Dr. MacArthur opened Follett’s chest so he could observe her aorta and be prepared to intervene if problems arose during the delivery.

As obstetrician, Dr. Billy Wong, began the emergency caesarean section, he knew he had a very urgent and delicate situation on his hands. “It was intense but we all knew what we had to do and we did it,” Dr. Wong says. He delivered a tiny baby girl—a highly unusual event inside a cardiac operating room.

Capital Health’s Stollery Children’s Hospital neonatal intensive care team—standing by the operating room—immediately took over the premature infant’s care.

The cardiac team then repaired Follett’s ruptured aorta in a procedure that took another eight hours. In total, the two operations took more than 13 hours and involved more than a dozen people in the operating room, including two perfusionists, two scrub nurses, and two circulating nurses.

The complex case was the first time in Canada a baby has been born during open-heart surgery and one of only a handful of documented cases in the world. “I’ve never seen anything like this in all my years as a surgeon,” says Dr. MacArthur. “My thanks goes to everyone in Capital Health who pulled together to make it happen.”

No one is more grateful than Roxanne Follett and her family. “This is a very special baby,” Follett says. “If I hadn’t been pregnant maybe the doctors wouldn’t have found the ruptured aorta so in that sense, my baby saved my life.”

“I feel like I just won a million dollars – only I didn’t get the money,” says her husband, Douglas Follett. “But I got two lives—and that’s better.”