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Twin to Transfusion Syndrome and Aortic Stenosis

In 2020, Mollie Haley found out she was pregnant with twins. However, the twins had a very rare syndrome called TTTS (Twin to Transfusion Syndrome). The condition can occur in identical twin pregnancies where the twins share a placenta (monochorionic). In TTTS, abnormal blood vessel connections in the shared placenta cause an imbalance in blood flow between the twins. One twin (the "donor") gives too much blood to the other twin (the "recipient"), leading to complications.

The procedure, selective fetoscopic laser photocoagulation, is the standard of care for severe TTTS. It is a minimally invasive surgical procedure that uses a small camera (fetoscope) to locate abnormal blood vessel connections in the placenta and disconnect (cauterize) them using a laser. Haley underwent the surgery at Texas Children’s Hospital when she was 17 weeks pregnant. She spent five days at the hospital and continued to be monitored weekly to ensure the babies had adequate blood flow.

Banks was always doing much better than Bronson until, at around 26 weeks, the ultrasound technician found a problem with his heart: aortic valve stenosis, which occurs when the valve is too narrow or blocked and can cause heart failure in the first days of life.

“We were told he would need a procedure when he was born to correct it. Initially, my heart broke because nobody wants to hear that their newborn has to go through heart surgery,” Haley explained. “I tried not to stress and worry because I knew everything was going to be alright.  I just felt at peace about everything. I always told myself God’s got this.”

The twins were born on June 17, 2021, at the UAB Medicine Women and Infants Center. Banks was then taken to Children’s of Alabama and had an emergent balloon aortic valvuloplasty heart catheterization the day he was born, performed by Cardiologist Mark Law, MD. After they left the hospital and returned home with the twins, they were instructed to see Cardiologist Khalisa Syeda, DO at Children’s.

“Banks was such a sweet and happy baby,” said Haley. “We knew it was time for surgery when he was tiring out easily. He would take three to four long naps a day when his brother only needed one nap.”

On May 31, 2022, Banks had his first open heart surgery performed by David Cleveland and Rob Sorabella at Children’s. He underwent a Ross operation where the diseased aortic valve was replaced using Banks’ own pulmonary valve, saving Bank’s life.

Banks spent five days in the hospital. “If he needed anything, they were always so close by and came as quick as they could,” said Haley. “We couldn’t ask for a better hospital or staff. Everyone we encountered was so friendly and knowledgeable. They kept us very informed of how Banks was doing the entire time while his surgery was going on. This was a very long surgery, and it was nice to have updates on how he was doing the entire time.”

He recovered well at home and never showed signs of pain. “Banks received so much love and extra cuddles during his recovery time,” added Haley.

Haley said Banks and Bronson enjoy life with their older sister, Sutton. They love playing cars and building blocks together. Neither are afraid to get rough and tackle each other, just like all little boys like to do. “They are each other’s best friend.”