Fixing heart defects is what the Kosair Children’s Hospital Heart Center team does. But little Ava Delaney’s issues were extremely complex and required four surgeries in one to repair them. Our photographer spent the day in the operating room, following Ava’s progress. Get a behind-the-scenes look at what it takes to repair a heart. Learn more about the Heart Center at KosairChildrensHospital.com/Heart-Center.

1. Ava’s storyComplex surgery for a complex heart
Photos by Jamie Rhodes, Norton Healthcare. © 2016
How the Heart Center repaired a toddler’s heart and vital structures

2. At age 1, Ava Delaney was living in an orphanage in China. You wouldn’t know it
to look at her, but she had life-threatening heart and organ defects. Ava was
placed on a website for adoption of children with special needs. The Delaney
family from Hardyville, Ky., adopted Ava and found themselves in Louisville at
the children’s hospital.

3. Ava has severe heterotaxy, which
means her organs are not on the
correct side of the body.
Several very complex heart defects
included dextrocardia, in which her
heart points to the right instead of
the left.
She also has an incorrectly
developed pulmonary valve and
artery. All of these very serious
issues affected Ava’s ability to
circulate and oxygenate blood
throughout her body.

4. To repair Ava’s heart would take a day-long surgery (actually, four
surgeries in one) performed by specialists in the Heart Center.

5. On April 27, 2016, Ava’s mom, Catherine, prepared for the long day
ahead — a day that would hopefully bring relief to her daughter.

6. Ava is curious about the things around her and loves name badges.

7. Pediatric anesthesiologist Steve Auden, M.D., explains what he would
do and reassures Catherine just before the surgery.

8. Finally, it’s time to go to the surgery suites. “The lord gives you strength
when you need it,” said mom, Catherine.

9. The Heart Center operating room team has everything ready for Ava’s
difficult surgery, including a large number of clamps that the surgeon
would use.

10. Of course Ava would also need blood and plasma to help her body
through the ordeal.

11. Ava arrives in the operating room, and IV lines are inserted so the team
could deliver medication during the procedure. Last-minute lab work
also is done.

12. Now that Ava is asleep, Dr. Auden places a central line, which is used to
quickly give medications that affect the heart, take blood samples and
give other necessary fluids.

13. Frank Pigula, M.D., chief of cardiovascular surgery, gets ready to begin.

14. After a last-minute review of the plan, it is time to start.

15. Dr. Pigula came to
our children’s hospital and
University of Louisville Physicians
from Children’s Hospital of Boston,
where he was the clinical director
of the pediatric cardiac surgery
program, rated No. 1 in cardiology
and heart surgery by U.S. News &
World Report. Dr. Pigula also was
an associate professor of surgery
at Harvard University School of
Medicine.

16. The team works through the day. Procedures included a TAPVR repair, a
hemi-mustard, a repair of Ava’s complete AV canal defect and repair of
the pulmonary arteries. In other words, they repair her heart.

17. “We’re doing some things here that we haven’t done before,” said
Dr. Pigula, who is also co-director of the Heart Center. “I feel honored I
was able to contribute and help Ava.”

18. “I don’t look at it as just a hospital,” said mom, Catherine. “I feel like it’s
family. I’m amazed at everything that was done for our daughter.”

19. “I hope Ava can be an inspiration for other
families whose children need heart surgery.”
- Catherine Delaney