For 6 1/2 touch-and-go hours, doctors didn't know if Margarita Espinoza would survive emergency heart surgery - or if they could save her 2-pound, 10-ounce daughter they were delivering.
"Everybody was really quiet. You could hear a pin drop," said Dr. Ismael Nuno, a cardiac surgeon at The Hospital of the Good Samaritan. "When the baby started crying, everybody started cheering. At least we had one life going. The deal was to get the second one through."The doctors succeeded.
"It's a miracle. I thank God I'm alive, and I thank God my baby's alive," the 38-year-old Espinoza said Friday.
She and her daughter, born two months premature, were doing well four days after the lifesaving combination of emergency bypass surgery, a Caesarean section and a hysterectomy.
"All things being equal, the way things look right now, I think we're going to have two survivors," Nuno said.
Espinoza's case is unusual for more than just the triple surgery.
She had no history of heart disease and was seven months pregnant when she began having chest pains and trouble breathing on Aug. 2. She was rushed to St. Francis Medical Center, where doctors resuscitated her and determined she'd suffered a massive heart attack.
At Good Samaritan, where she was transferred Monday, Dr. Ray Matthews found her arteries blocked.
Faced with no choice but surgery to save her life and that of her baby, Espinoza agreed to undergo the combined triple-bypass and surgical delivery of the child. The hysterectomy was needed to keep her from bleeding to death because of blood thinners used for the cardiac surgery.
Just 45 minutes after she'd seen Matthews, Espinoza was wheeled into the operating room, where doctors administered anesthesia and opened up her chest. Before Nuno stopped her heart, Dr. Mark Dwight delivered the baby.
The girl needed brief resuscitation from the effects of her mother's anesthesia before she was taken to the neonatal intensive care unit.
After Dwight removed Espi-noza's uterus, Nuno stopped her heart and performed the bypass surgery.
Espinoza was suffering from dissected coronary arteries, which occur when a tear in the lining of the arteries lets blood into a false channel, where it blocks off its own flow.
"You can have a normal heart up to that second," Nuno said. "It's a lethal problem unless taken to the operating room right away."
Dr. Ezra Davidson, chairman of obstetrics and gynecology at Martin Luther King-Drew Medical Center in Los Angeles, called the survival of mother and daughter "a tribute to how we do high-tech medicine in this country."
He said the baby's prognosis was "not ideal but good."