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"Miracle Miranda" thriving after four heart surgeries

Randall Children's Hospital at Legacy Emanuel | Heart Care, Children's

Tod and Lorie Case’s joy at the impending birth of their second daughter, Miranda, was tempered by trepidation because they knew she had hypoplastic left heart syndrome. The couple remained hopeful, however, because they knew treatment for this once-fatal congenital defect existed.

A complex three-stage surgery is the gold standard for treating hypoplastic left heart syndrome. John Iguidbashian, M.D., a pediatric cardiothoracic surgeon at Randall Children’s Hospital at Legacy Emanuel, is one of the region’s most experienced surgeons in this staged reconstruction. The Pendleton couple sought him out, and their two-year journey to rebuild their daughter’s heart began.

After Miranda was born via cesarean section at Legacy Emanuel Medical Center in March 2007, she was admitted to the NICU. Her first open-heart surgery –– the Norwood operation –– took place one week later, during which Dr. Iguidbashian divided the pulmonary artery and attached both ends to the aorta, the distal end via a prosthetic graft.

Six months later, the Cases returned to Portland for Miranda’s stage II operation, the Glenn shunt. This procedure connected the superior vena cava directly to the pulmonary arteries. Miranda remained in the hospital for nine days. Then, in July 2011, they returned to Legacy for Miranda’s third operation, the Fontan procedure, during which the veins carrying blue blood from the body (inferior vena cava) are connected directly to the blood vessels to the lungs. She later had a fourth surgery.

Today, Miranda is doing very well, Lorie reports. “She is going to school and loves it. She is playing whiffle ball, enjoys coloring and craft projects, the swings and riding her bike.

“We appreciate all the staff at Legacy,” she continues, singling out many of the staff, pediatric cardiologists Peter Chang, D.O., and James Kyser, M.D., and, mostly, Dr. Iguidbashian. “Because of his knowledge and surgery skills, we have a wonderful little girl running around our house.”