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Comprehensive Care

A New Mother’s Heart

In the surgery waiting unit at Texas Health Presbyterian Hospital Dallas, Shea Bowen put her hands together. Her husband, Bobby, kissed her forehead. Dr. Mark Pool, a cardiothoracic surgeon on the hospital’s medical staff, leaned over her bed, bowed his head and led them in prayer.

Shea and Bobby Bowen live in Kaufman, Texas, with their young son.
Shea and Bobby Bowen live in Kaufman, Texas, with their young son.

This is not where the 26-year-old new mom expected to be: just minutes from open heart surgery to save her life. She had a large tumor in her heart that, if left unchecked, could cause heart failure, a catastrophic stroke or death.

A day earlier, Shea had given birth to her first child, a healthy 7-pound, 5-ounce boy, at Texas Health Presbyterian Hospital Rockwall. But hours after giving birth, Shea developed severe shortness of breath. Her oxygen levels had been a bit low during delivery, but that was chalked up to the stress of labor.

With no explanation for her shallow breath, doctors on the medical staff at Texas Health Rockwall continued to investigate.

“The work to diagnose her condition at Texas Health Rockwall was excellent because these symptoms can be commonly experienced during pregnancy and labor,” Dr. Pool said. “But the physicians didn’t dismiss the symptoms. They kept working. And they worked quickly.”

Shea was immediately put through a battery of tests, including a CT scan that ruled out a pulmonary embolism — a blood clot in the arteries of the lungs that would have explained her shortness of breath.

An echocardiogram — a special ultrasound test of the heart — was also performed. The images showed a large tumor, called an atrial myxoma, in the left side of her heart. With every beat of her heart, the movement of blood tried to suck the tumor through the mitral valve, which directs blood from the left atrium into the left ventricle, the high-pressure chamber of the heart that pumps blood throughout the body. It delivers oxygen-rich blood to vital abdominal organs, the skin, the lower legs and the brain.

These tumors can lodge firmly in the middle of the mitral valve, preventing the movement of blood and causing the heart to fail. If the blockage of blood is complete, no blood can move, and the patient will die.

“There’s another concern when you have a mass in the heart that’s being jostled around,” Dr. Pool said. “A tiny piece of the tumor can break off and travel to the brain, causing a stroke. It’s also possible for a tiny piece to break off and travel to a coronary artery, causing a heart attack.”

Shea was quickly rushed to Texas Health Dallas.

“Excellent coordination and communication of the facilities and caregivers allowed us to be ready for Shea,” Dr. Pool said. “It is refreshing to see a complex system work so efficiently and effectively to help a patient.”

After telling Shea and her husband about the gravity of the situation and explaining the need for open-heart surgery, Dr. Pool stepped away to give the young couple a few minutes alone.

“Bobby and I talked about how we felt like we were meant to be there, that everything would be OK,” she recalls. “Then Dr. Pool came back, and we told him we were ready.”

To remove the tumor, Dr. Pool performed open-heart surgery with cardiopulmonary bypass. He had to open her chest, stop her heart and cut out the tumor. The cardiopulmonary bypass machine kept her alive while her heart was stopped.

Another echocardiogram that was performed in the operating room pinpointed the exact location of the tumor. Dr. Pool cut out the tumor from the middle of the heart, where it was attached to the cardiac muscle.

“The tumor was large and oddly shaped, with pieces that looked like branches,” Dr. Pool said. “But its base, where it attached to the heart muscle, was quite small. I made an incision in the heart itself to access it. I removed the mass and cut out the small piece of the muscle where the mass attached. I then closed this hole with a piece of Shea’s own tissue. I used her pericardium, the sac that is normally around the heart.”

When Shea’s heart was restarted, the beat was immediately strong, Dr. Pool said.

After the four-hour surgery, Shea woke up in the intensive care unit. She had not had a stroke, heart failure or a heart attack. Four days later, she returned to her home in Kaufman, Texas, with her husband, newborn son and a new lease on life. The pathology report revealed that the mass was indeed an atrial myoxma, which is benign.

“Since this type of mass does not run in her family, there is only a very small chance that it will ever come back,” Dr. Pool said. “It’s not known why they develop in the first place.”

Today Shea suffers no ill effects from the tumor or the surgery. A scar on her chest is the only sign of what she went through.

Get more information on heart and vascular care at Texas Health Dallas and find out your Heart Age.

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