On the day she was scheduled to get the LVAD at the UK Gill Heart & Vascular Institute, Alexis learned of her fourth pregnancy through pre-surgical testing. Alexis knew the risks this presented for herself as well as the baby.

Story by: Lynne Choate on March 22, 2023

At age 25, Alexis Helm had been pregnant three times, and her heart was failing. The increased blood volume from her pregnancies and strain on her heart muscle had taken a toll, as it does with many women.

With her fourth pregnancy, she knew she risked damaging her heart further but wanted to do all she could to carry the baby.

Alexis’ heart condition — advanced cardiomyopathy — was diagnosed just one year earlier, after the birth of her third child.

“At 25 years old I was struggling to do everyday things,” Alexis said. “I was short of breath. It was difficult to walk up stairs, and I struggled to carry my kids and play with them outside.”

Alexis started working with Kelly C. McCants, M.D., executive medical director of the Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program. Dr. McCants and Natalie K. Kendall, APRN, nurse practitioner with the Advanced Heart Failure & Recovery Program, started Alexis with intravenous infusions of medication. They would manage her symptoms for a time, but it became clear medication wouldn’t be a long-term solution.

Ready for an artificial heart pump, then a pregnancy is discovered

Dr. McCants, who is also executive director, Institute for Health Equity, a Part of Norton Healthcare, is board certified in cardiovascular disease, advanced heart failure and transplant cardiology. He and the team recommended Alexis turn to an increasingly common long-term solution.

“We felt that she was going to require more for her heart, which would be an artificial heart pump,” said Kendall.

The pump, otherwise known as a left ventricular assist device, or LVAD, would be surgically implanted into Alexis’ heart, taking over the work of the damaged left ventricle that was no longer pumping sufficient amounts of freshly oxygenated blood throughout her body.

On the day she was scheduled to get the LVAD, Alexis learned of her fourth pregnancy through pre-surgical testing. Alexis knew the risks this presented for herself as well as the baby. She was only about 10 weeks along in her fourth pregnancy and was faced with a very difficult decision.

READ MORE: When to worry about breathing issues during pregnancy — what to watch for and what it might mean

“I still wanted to have my baby,” she said. “When I told Dr. McCants and Natalie that I’d rather chance it and carry the baby to term, they were both supportive and ready to face the challenge with me.”

The team set up weekly appointments — some in person, some held via Norton Telehealth video visits. They managed her medications and monitored her heart rate, weight gain and blood pressure.

“We knew it was going to be a very big challenge to keep mom and baby healthy,” Natalie said. “Alexis’ situation was quite unique. There is little to no literature or research to reference such a case, which meant we were entering unknown territory.”

Nearly seven months after canceling her LVAD surgery, Alexis gave birth to a baby girl.

The baby’s birth weight was low, and she was admitted to the Norton Children’s Hospital neonatal intensive care unit (NICU).

“The baby was very healthy and required minimal NICU intervention,” Natalie said. “And Alexis did very well during the delivery and recovery. We were able to support her heart with medications to manage the stress of carrying the baby and delivery.”

With a 5-month at home, Alexis gets an LVAD

Five months after the baby was born, Alexis was able to reschedule her LVAD surgery through the UK Gill Heart & Vascular Institute’s Gill Affiliate Network. Today, she is on the mend and better able to get back to being a mom.

“I’m able to take care of my kids; I’m able to play with them. I’m able to walk up the stairs — but I notice that I have to go slower,” she said.

Though her symptoms have vastly improved, this isn’t the end of Alexis’ heart-healing journey.

“The LVAD is currently allowing Alexis to have improvements to symptoms and quality of life but the best long-term solution for a young female would be a heart transplant,”  Natalie said. “This is our ultimate goal for her.”

Alexis continues working with the Advanced Heart Failure & Recovery Program team to strengthen her heart and take the steps necessary to qualify for a transplant.

“They’re really great,” she said of the heart team. “They call. They check up on me. They make sure I get to the doctor.”

If she needs transportation, they find a way for her to get to the clinic. If she doesn’t have child care, they make accommodations for her children to come along on her office appointments. And if she has other health questions or concerns, they provide resources.

“I feel like if I had gone somewhere else, they wouldn’t have given me the care that Norton has provided,” she said.

Photos courtesy of Mary Helen Nunn for Today’s Woman magazine