At 15 months old, she weighed only 5.5 kg.

She had been born at just 28 weeks of pregnancy, diagnosed with a complex congenital heart defect, undergone an earlier palliative cardiac procedure, and spent much of her short life moving between hospitals.

By the time she was hospitalized in Xuzhou, her condition had deteriorated badly.

Her oxygen saturation had previously fallen to around 60%.

She had severe pneumonia, chronic lung disease related to extreme prematurity, pulmonary hypertension, poor cardiac function and persistent hypoxemia.

Several hospitals had considered definitive heart surgery too risky.

Her parents had already spent more than a year seeking treatment.

Then, in 2023, a team from Shenzhen Children’s Hospital became involved.

But the challenge was not simply finding a surgeon willing to operate.

Before the doctors could repair her heart, they first had to make her lungs strong enough to survive the operation.

This is the story of a child with a complete atrioventricular canal defect (CAVC) — also known as a complete atrioventricular septal defect (CAVSD) — and the staged treatment that eventually allowed her to undergo definitive heart surgery in Shenzhen.

Note: This article is based on a publicly documented pediatric cardiac case filmed in China in 2023. The child was not a China MedCare patient.

Born at 28 Weeks With a Complete AV Canal Defect

The child came from a family in Liaoning Province.

She was born prematurely at approximately 28 weeks, which meant her lungs were still significantly underdeveloped at birth.

During her early hospitalization, doctors also discovered a serious congenital heart defect:

Complete atrioventricular canal defect, or CAVC.

A complete AV canal defect is more complex than a simple “hole in the heart.”

The center of the heart does not form normally. There are defects between the upper and lower chambers, and the atrioventricular valves are also abnormal.

In practical terms, the condition may involve a combination of:

a defect between the atria, a defect between the ventricles, and abnormal formation of the valves controlling blood flow between the upper and lower chambers.

This abnormal circulation can place significant stress on both the heart and lungs.

Because she was extremely premature and medically fragile, doctors did not immediately perform a full intracardiac repair.

Instead, when she was around three months old, she underwent pulmonary artery banding.

Pulmonary Artery Banding Bought Time — But Did Not Repair the Heart

Pulmonary artery banding, often abbreviated as PAB, can be used as a temporary or palliative procedure in selected infants who are not yet suitable for complete repair.

The operation places a band around the pulmonary artery to limit excessive blood flow to the lungs.

For a very small or unstable infant, this can buy time.

But it does not correct the underlying CAVC.

The expectation is that the child will later undergo definitive repair when her condition allows.

In this case, that complete repair did not happen soon afterward.

Months passed.

As the child grew, her congenital heart defect remained, while the pulmonary artery band continued to restrict pulmonary blood flow.

At the same time, the long-term consequences of being born at 28 weeks became increasingly important.

Her Heart Was Only Part of the Problem

Because of her extreme prematurity, the child's lungs had not developed normally.

She had significant chronic lung disease consistent with bronchopulmonary dysplasia, a condition commonly associated with very premature infants.

She also suffered repeated respiratory infections.

Eventually, she developed severe pneumonia on top of her already compromised lungs.

By 1 year and 3 months of age, she weighed only 5.5 kg.

Her doctors were no longer dealing with just one disease.

They were dealing with a combination of:

complete AV canal defect, previous pulmonary artery banding, chronic lung disease, severe pneumonia, pulmonary hypertension, low oxygen levels, poor cardiac function and severe growth failure.

This created a difficult clinical dilemma.

Without definitive heart surgery, her condition was unlikely to improve.

But performing open-heart surgery while she had severe pneumonia and poor lung function also carried enormous risk.

For that reason, several hospitals had been reluctant to proceed.

Even Getting Her to Shenzhen Was a Medical Challenge

While the child was being treated in Xuzhou, Dr. Liang Suixin from Shenzhen Children’s Hospital became involved in evaluating her respiratory and critical-care condition.

At that time, even long-distance transfer was risky.

Her oxygen saturation had previously fallen to around 60%, and she required significant respiratory and cardiovascular support.

The medical team first worked to stabilize her.

Treatment included improving oxygenation, supporting her circulation and reducing excess fluid affecting the lungs.

Only after her oxygen saturation became more stable — approximately 80% before transport — did the team proceed with the transfer from Xuzhou to Shenzhen.

Reaching Shenzhen Children’s Hospital was a major milestone.

But she still was not ready for heart surgery.

The First Priority at Shenzhen Children’s Hospital Was Her Lungs

This is one of the most important parts of the case.

The heart defect clearly required definitive repair.

But the team believed her lungs were not yet in a condition to tolerate cardiopulmonary bypass and major open-heart surgery.

Under the respiratory and critical-care management of Dr. Liang Suixin and the hospital team, treatment first focused on controlling the severe pulmonary infection and improving the lung function that could still be recovered.

The documentary showed treatment that included respiratory support, bronchoscopy, airway assessment, respiratory sample collection, adjustment of antibiotics, airway clearance, fluid management and efforts to improve ventilation in poorly functioning areas of the lungs.

One of the doctors used a particularly vivid analogy.

Her lungs were compared to an unfinished building.

The team could not build a completely new lung in a few days.

But they could try to make as many usable “rooms” functional again as possible.

The immediate goal was not to cure her chronic lung disease.

It was to improve her condition enough to make heart surgery survivable.

Six Days Later, the Situation Looked Different

After approximately six days of intensive treatment, her condition improved noticeably.

Her fever settled.

Her respiratory status became more stable.

She progressed away from invasive mechanical ventilation toward less intensive respiratory support.

Her overall condition also improved.

The hospital then carried out another multidisciplinary assessment.

This time, the conclusion was different.

The team believed that her respiratory status had improved enough for her to proceed with definitive heart surgery.

She was still a high-risk patient.

But she was no longer considered too unstable to operate.

This is an important distinction in complex congenital heart disease.

A child who is not ready for surgery today is not necessarily a child who can never have surgery.

In selected cases, infection, respiratory failure, nutrition or other reversible problems can sometimes be treated first, followed by reassessment.

Whether that is possible depends entirely on the individual child.

Dr. Chen Xinxin and the Cardiac Team Took on the Next Challenge

Once the pulmonary infection had improved and the multidisciplinary team agreed that surgery was possible, attention shifted to the heart.

The cardiac surgical treatment was handled by Dr. Chen Xinxin and the cardiac team at Shenzhen Children’s Hospital.

This was not the child's first chest operation.

Because she had already undergone pulmonary artery banding, the surgeons were facing a repeat sternotomy.

After previous cardiac surgery, scar tissue and adhesions may form between the heart and surrounding tissues.

That can make reopening the chest significantly more difficult than a first operation.

The surgeons first had to carefully separate these tissues before they could even begin repairing the intracardiac defect.

Then came the definitive CAVC repair.

What Did the Complete AV Canal Repair Involve?

There are four key steps in the operation.

Step 1: Repairing the ventricular septal defect

The opening between the two ventricles was closed.

Step 2: Reconstructing the left atrioventricular valve

The left-sided atrioventricular valve required repair so that it could close more effectively and reduce regurgitation.

Step 3: Closing the primum atrial septal defect

The lower portion of the defect between the two atria was repaired.

Step 4: Repairing the right atrioventricular valve

The right-sided atrioventricular valve was also reconstructed.

Patch material, including bovine pericardium, was used as part of the repair.

One of the most technically demanding parts of the operation was the valve reconstruction.

The child's left-sided valve defect was substantial, while the available native valve tissue was limited.

For a very small child, the position and depth of each stitch can affect whether the reconstructed valve closes properly afterward.

The heart repair was completed successfully.

But the doctors were still concerned about what would happen next.

The Greatest Postoperative Concern Was Her Lung Function

Before surgery, the medical team had discussed the worst-case scenarios with the family.

Even if the heart repair itself went well, there was a possibility that the child's lungs would not be able to support her after the operation.

She had been born at 28 weeks.

She had chronic lung disease.

She had only recently recovered from severe pneumonia.

Prolonged respiratory failure and an extended intensive-care stay were real possibilities.

Her parents understood the risk.

After more than a year of seeking treatment, they decided to proceed.

By the Second Day After Surgery, the Invasive Ventilator Was Removed

Her recovery was better than the team had feared.

After the heart defect was repaired, her cardiac function improved significantly.

By the second day after surgery, doctors were able to remove invasive mechanical ventilation.

Her cardiovascular medications were gradually stopped.

She began eating again.

Respiratory support was reduced step by step.

Eventually, she was able to leave intensive care and continue her recovery with her parents.

The central cardiac defect that had affected her since birth had finally been repaired.

But the doctors were careful to explain that surgery could not instantly reverse the lung damage caused by extreme prematurity.

Her chronic pulmonary condition would still require time.

The priorities after discharge included preventing respiratory infections, improving nutrition, helping her gain weight and allowing her lungs to continue developing as she grew.

The medical team hoped that by approximately 4 to 6 years of age, her chronic pulmonary condition could gradually improve toward a much more normal level.

After months of uncertainty, repeated hospitalization and unsuccessful attempts to find a definitive solution, she was finally able to go home.

Why This Case Matters

The most important part of this story is not simply that a difficult operation succeeded.

It is the sequence of treatment.

The doctors did not look at a critically ill child with severe pneumonia and immediately take her to the operating room.

They first asked:

What is stopping this child from safely undergoing heart surgery?

In her case, one of the biggest immediate obstacles was the condition of her lungs.

The treatment pathway therefore became:

Stabilization in Xuzhou → medical transfer to Shenzhen → intensive treatment of severe pneumonia and lung dysfunction → multidisciplinary reassessment → CAVC repair → postoperative respiratory recovery → discharge.

For families facing complex congenital heart disease, this distinction can be very important.

Sometimes the question is not simply:

“Can the heart defect be repaired?”

The more useful question may be:

“What needs to be improved before this child can safely undergo the repair?”

For one patient, the answer may be infection control.

For another, it may be nutrition, pulmonary hypertension, organ function or additional cardiac imaging.

That is why children with complex congenital heart disease often require evaluation by a multidisciplinary pediatric cardiac team rather than a decision based only on the name of the diagnosis.

How Much Does Pediatric Congenital Heart Surgery Cost in China?

The 2023 documentary did not disclose the hospital bill for this child's final admission and CAVC repair at Shenzhen Children’s Hospital.

Because the exact cost of this admission was not disclosed, two publicly shared hospital bills from other pediatric congenital heart disease cases can provide some general cost context.

What Records Are Usually Needed Before a Chinese Pediatric Heart Center Can Review a Case?

For an international child with complex congenital heart disease, a diagnosis alone is usually not enough to determine whether surgery is possible.

Hospitals may need to review recent echocardiography, cardiac CT or CT angiography when available, previous cardiac surgery records, current oxygen saturation, current weight, medication history, recent laboratory results, respiratory support requirements and details of any recent ICU admission or infection.

For medically fragile children, fitness for air travel should also be discussed with the child's treating cardiologist before international travel is planned.

This is especially important for infants with low oxygen saturation, pulmonary hypertension or significant respiratory disease.

Considering Congenital Heart Treatment in Shenzhen?

China MedCare is not a hospital and does not provide medical treatment.

For international families considering pediatric cardiac treatment in Shenzhen, we can help organize medical records, communicate the case to appropriate hospital teams, coordinate appointments and assist with local treatment and travel logistics after a medical team has reviewed the child's condition.

For complicated congenital heart disease, the first step should usually be medical record review, not booking a flight.

That allows the cardiac team to assess whether treatment may be possible, what additional testing is required and whether the child is currently stable enough to travel.

Medical Disclaimer: This article is for general informational purposes only. Every congenital heart defect is different. Treatment timing, surgical candidacy, travel safety and expected outcomes must be determined by qualified pediatric cardiology, cardiac surgery and critical-care specialists after reviewing the individual child's condition.