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One New Heart Valve Saves Two Lives-Tritten-Story

A South Jersey woman needed a new heart valve while pregnant. Experts from Virtua Health performed the first-of-its-kind procedure – saving the lives of both mother and baby.

Updated September 04, 2020
A South Jersey woman needed a new heart valve while pregnant. Experts from Virtua Health performed the first-of-its-kind procedure – saving the lives of both mother and baby.
 
Elenilza Tritten developed heart problems as a child, and had her mitral valve replaced at age 18. Last year, her heart symptoms started to return, causing her to feel tired and breathless. 
 
Elen knew she might need another valve replacement. But this time, there was a major complication: The Mount Laurel woman, then 25 and newly married, had just discovered she was pregnant. 
 
“It was very scary,” said Elen.
 
The pregnancy made treatment both riskier and more urgent, according to Ibrahim Moussa, DO, FACC, FSCAI, Elen’s interventional cardiologist at Virtua Health.
 
“Elen would not be able to carry her baby to term or survive the stress of delivering a baby without correcting her valve disease,” said Dr. Moussa, medical director of the Structural Heart Program at Virtua Our Lady of Lourdes Hospital in Camden. The hospital is well known for its advanced cardiology services.
 
Ticking Clock 
 
Dr. Moussa and cardiothoracic surgeon Arthur Martella, MD, led a team of experts from multiple disciplines across Virtua Health – including obstetrics, maternal-fetal medicine, anesthesiology, and intensive care – to create a plan for replacing Elen’s mitral valve.
 
The team had to act quickly, as Elen’s body was continually producing more blood to cope with the growing demands of pregnancy. Without a new valve to handle the increased flow, the lives of the fetus and mother would be at risk.
 
“By the time she got to that third trimester, she would be in heart failure,” said Dr. Martella, chief of cardiothoracic surgery at the hospital.
 
Medical First
 
Last April, in Elen’s 16th week of pregnancy, the team’s plan came to fruition – and everyone involved made history.
 
Elen is the first pregnant woman to receive a new mitral valve through a unique, minimally invasive procedure.
 
The valve Elen received is commonly used in transcatheter aortic valve replacement (TAVR), but is also approved for transcatheter mitral valve replacement (TMVR) — an option for people who cannot safely have open-heart surgery. The cardiac team threaded the valve through a thin tube (called a catheter) into Elen’s heart. Once in place inside the old valve, the new valve was expanded.
 
It pushed aside the leaflets of the old valve and began to work immediately.
 
“Everything went perfect,” said her husband Taylor, recalling the complex planning for Elen’s procedure. “They had so many different precautions, we felt safe.” 
 
High-Risk Pregnancy without Precedent
 
Even after the successful valve replacement, Elen still faced a risky pregnancy and delivery due to her heart issues.
 
Elen’s heart surgeons and a team of other Virtua experts (including OB/GYN and maternal fetal medicine physicians) provided care and planning throughout her pregnancy to ensure a safe and healthy delivery for both mom and baby.
 
Elen had a planned C-section to reduce the strain on her heart from giving birth, and to enable her to deliver her baby in a controlled situation. In fact, the delivery took place in an operating room that could also handle potential cardiac issues, with Elen’s same team of heart specialists and other experts on hand.
 
“They’re kind of like an extended family because they care so much,” noted Taylor.
 
Elen gave birth to son Denver on October 1, 2019, at Virtua Our Lady of Lourdes Hospital. Taylor was at her side to welcome their baby, who weighed 7 lbs., 13 oz.
 
“I’m doing great; my son is super healthy,” said Elen, who is grateful for Virtua’s care. “It’s incredible what they did.” 
 
Comprehensive Cardiac Care is Just a Heartbeat Away
 
Need to see a heart specialist? New patients see one of our high-quality cardiologists within 48 hours. Call 844-932-8444 to make an appointment or visit www.virtua.org/heart to learn more.