The birth defect is called ectopia cordis – Latin for heart outside.
It’s extremely rare, about eight in one million births. Doctors say most babies born this way are stillborn or die within a few days.
Dr. Carolyn Altman is a pediatric cardiologist who is caring for the patient, Audrina Cardenas.
She said Audrina’s heart was only partially exposed, which gave her a better chance.
“There’s a wide range of possibilities of what could be wrong. So this little one had probably about a third to a half of the heart outside the chest. There are some for example that have the entire heart outside the chest. So this one you saw the little heart sitting like a little button or a dumbbell sticking outside the chest? There are ones that are so severe where it’s actually totally out and upside down and pointing towards the chin.”
WARNING: This video contains graphic medical imagery.
Audrina had a few things going for her.
First, a doctor in Midland spotted the condition early in the pregnancy. That gave the doctors time to plan the surgery, and for her mother to arrange to deliver in Houston.
The surgery took place Oct. 16, one day after a planned C-section. And, it helped that Audrina was not premature and had no other major health problems.
Dr. Charles Fraser led the surgical team at Texas Children’s Hospital.
“The first shock was just seeing the heart outside the body. I mean, having looked at thousands of hearts, just seeing that image of a major portion of the heart outside the chest wall, and seeing it pumping away.”
The team had to create space inside the baby’s chest to lower the entire heart back inside.
Then a pediatric plastic surgeon, Dr. Larry Hollier, had to stretch skin and muscle over the hole to close it.
Mother Ashley Cardenas with baby Audrina. Image provided by Texas Children's Hospital.
The surgery occurred five weeks ago. Dr. Hollier:
“I can report to you that the child has done phenomenally great, with some minor medical issues but we expect the child to have a very normal existence. In the future we’re hopeful that the heart will seat a little better, deeper within the chest cavity. But if it doesn’t, we’re certainly capable of providing a little more structural support to better protect it.”
The baby’s mother, Ashley Cardenas, is 25 and has two older twins in Odessa.
She says it was a hard decision to make, but she’s glad she and her husband decided to continue the pregnancy.
“It was all kinds of emotions. They tell you ‘This is what it is. This is what we found. This is how her heart is outside of her chest.’ You don’t know what to think, you don’t know what to say.”
In a few years, doctors may construct a new sternum bone over Audrina’s heart to help protect it even further.
Baby Audrina Cardenas smiles at the camera.