Hybrid Operating Room – Not Your Typical Delivery Room

Private: Prem Shekar, MD
Contributor Prem Shekar, MD

It’s not every day that a baby is born in the Brigham and Women’s Hospital cardiovascular hybrid operating room (OR), but that’s where a multidisciplinary cardiovascular and obstetrics team was at the ready as 29-year-old Chelsea Phaneuf delivered her daughter, Aria. Chelsea had been admitted to the Shapiro Cardiovascular Center with a failing heart valve about a month before Aria’s arrival.

At the age of 23, an echocardiogram showed that Chelsea’s bicuspid valve had suddenly deteriorated and needed to be replaced. At such a young age, Chelsea was concerned about how the surgery would impact planning for a future family. The daily blood-thinning medication required for patients who undergo a valve replacement with a mechanical device is a risk to a developing fetus. Chelsea, therefore, opted for a biological valve, even though they don’t last as long as a mechanical valve.

After her valve replacement surgery, Chelsea got married and had a son, Logan. However, in her second trimester with Aria, she began experiencing dizziness and shortness of breath.

“My cardiologist did an echocardiogram, and we saw that the valve had deteriorated very quickly,” says Chelsea. “I was referred to the Brigham for care.”

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At BWH, a team of specialists from High-Risk Obstetrics (Maternal-Fetal Medicine), Cardiovascular Medicine, and Cardiac Surgery, as part of the Cardiovascular Disease and Pregnancy Program, collaborated to determine the best course of care for Chelsea and her baby. They developed a set of plans that included delivering her baby in the cardiovascular hybrid OR, one of only a few such ORs in the country.

The hybrid OR’s design allows an entire multidisciplinary team of specialists to be in the same room at the same time to perform whatever diagnostic imaging, surgical or non-surgical procedures, or monitoring a patient needs. Combining the capabilities of this operating room with high-risk pregnancy and cardiovascular expertise was advantageous for a patient like Chelsea, who required simultaneous, cooperative care from more than one type of specialist.

Prem Shekar, MD, Chief of the Division of Cardiac Surgery, performed Chelsea’s second valve replacement surgery, which required extraordinary teamwork across several disciplines.

“We needed extensive plans in place for several scenarios that could have happened related to her delivery and her heart condition,” says Dr. Shekar, adding that Chelsea is one of only a few patients to deliver in the cardiovascular hybrid OR. “Fortunately, everything went smoothly with the delivery, and we were able to perform Chelsea’s valve replacement one week later.”

Aria was able to stay with her mom in the Shapiro Center and Chelsea’s husband, John, remained close by during their stay, spending some nights in a local hotel and some in the Shapiro Center. A week after Chelsea’s surgery, she and John were excited to bring Aria home to Belchertown, MA, and rejoin Logan.

“I felt so well taken care of at the Brigham, and I am thankful that I met so many caring people who wanted what was best for me and my family,” says Chelsea.

Private: Prem Shekar, MD
Prem Shekar, MD

Prem Shekar, MD, Chief of Cardiac Surgery and Surgical Director of the Heart and Vascular Center at Brigham and Women’s Hospital (BWH).

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