How TMH Helped a Tallahassee Mom Grow Her Family and Battle Heart Disease
Cassie was born at Tallahassee Memorial HealthCare (TMH) with a bicuspid aortic valve; an integral piece of her heart meant to have three leaflets had only two. Since then, TMH has been the common thread woven through every stage of Cassie’s life, from her own birth and her children’s high-risk deliveries to multiple complex heart procedures.
Like others born with her condition, Cassie’s symptoms didn’t present until adulthood. At 29 years old, she began experiencing debilitating shortness of breath. An echocardiogram (echo) revealed she’d need her aortic valve replaced.
“I had two months to process that I needed open heart surgery,” Cassie recalls. “I got a few opinions, and at Shands, the doctor said, ‘I don’t know why you’re here – you have an amazing cardiac surgeon in Tallahassee.’ ”
Cassie had already met with Dr. David Saint, cardiothoracic surgeon at TMH; she remembered loving his bedside manner. This recommendation sealed the deal.
Together, they decided on an open-heart bovine valve replacement. Cassie had one son, Gage, but wanted more kids. While a temporary solution, the bovine valve gave her the best chance at the fewest pregnancy complications later.
The surgery was a success. “A month later,” Cassie laughs, “I met the man I would marry.”
After tying the knot in 2016, Cassie and Patrick tried for three and a half years to get pregnant, while closely monitoring her heart. When an echo in 2019 showed her condition was worsening, Cassie’s cardiologist recommended she hold off on having more children.
One week later, she learned she was pregnant.
Cassie was immediately referred to the Valve Clinic at TMH Physician Partners, Services by Southern Medical Group, who closely monitored her condition.
“Our Valve Clinic is where we plan and streamline care for patients in our Structural Heart Program,” says Dr. Thomas Noel, interventional cardiologist and Co-Chair of TMH’s Structural Heart Program – the only one of its kind in the region. “Our interventional cardiologists and heart surgeons work together to evaluate patients’ unique needs and determine the best plan of care.”
The clinic also streamlines patients’ cardiac imaging. Cassie says registered sonographer Garrett Schroder, RDCS played a key role in her regular echos. “His expertise has always been vital in my care.”
At first, Cassie had no symptoms, but eventually, the shortness of breath returned with a vengeance. She and her obstetrician, Dr. David Dixon, decided to induce her labor three weeks early to avoid stress on her heart.
“I couldn’t walk without feeling like I couldn’t breathe. I couldn’t lay on my back. At one point, even sitting upright was hard,” Cassie says.
When the day arrived on August 27, 2020, Cassie’s heart was under such strain, her heart team worried childbirth could put her into a crisis. With her obstetrical team, they decided to deliver her daughter Harper in the operating room, in case Cassie needed emergency surgery.
“I’d come to grips with what may happen. I trusted the care team I had lined up. They coordinated so well together,” Cassie remembers.
One key member of that team was Joanna Fato, RN, BSN, Assistant Nurse Manager of the TMH’s High-Risk Labor & Delivery Unit.
“I cannot tell you how amazing she was,” Cassie shares. “She sat there the whole time, closely watching me, keeping me focused. I knew if I needed something, she was there looking at me to cue her.”
After just three pushes, Harper was born. Weighing a healthy 7 pounds and 2 ounces, she was everything Cassie imagined and more. They started skin-to-skin contact right away. Then Patrick came into the OR to hold his daughter for the first time while the doctors tended to Cassie.
Moments later, Cassie recalls, “I looked up at Joanna and said, ‘I can’t breathe.’ ”
The delivery had put her heart into further distress. Her care team stabilized her. She would still need another heart surgery, but not yet; the priority was letting her body heal.
When Cassie and her mom took Harper to the pediatrician a week later, Cassie couldn’t make it to the door. Together with Valve Clinic team members Ginny Smith, APRN and Catie Yarbrough, RN, BSN, Dr. Noel scheduled Cassie for a transcatheter aortic valve replacement (TAVR) the next day.
“My heart had worked so hard during the delivery, it was too enlarged for another open-heart surgery,” Cassie recalls. “I completely trusted Dr. Noel. If anyone did it, I wanted it to be him.”
TMH’s Structural Heart Team performs more TAVRs than anyone else in Northwest Florida.
“With TAVR, we deliver a small, stent-like valve to the heart using a catheter inserted through a tiny hole in the groin,” explains Dr. Noel. “TAVR lets us replace the valve without ever opening the chest.”
That was a relief for Cassie. The procedure went perfectly and almost instantaneously her symptoms were gone.
“It was incredible,” she remembers. “As soon as they opened the valve, I could finally breathe again.”
The next day, Cassie was back home with Harper, Gage and Patrick. She felt better than she had in years, and she credits every member of her care team at TMH with getting her there.
“I’ve been through so much medically. TMH has been my saving grace every time and will always hold a special place in my heart.”
To learn more about the advanced, interdisciplinary care available at Tallahassee Memorial, visit TMH.ORG.
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