But despite all the challenges, Trinity’s story is one of incredible resilience, strength and hope.
The Beginning of Her Journey
During her pregnancy, Roshawn received unsettling news when an ultrasound revealed an issue with her baby’s heart. Her OB/GYN referred her to The Fetal Center at Children's Memorial Hermann Hospital, where she was connected with a maternal-fetal medicine (MFM) physician and a fetal cardiologist.
Trinity’s care was overseen by Avichal Aggarwal, MD, a pediatric cardiologist affiliated with the Children's Heart Institute at Children’s Memorial Hermann Hospital, who worked closely with the rest of the affiliated cardiovascular surgery team to manage her complex case.
While at The Fetal Center, Trinity underwent a fetal echocardiogram to assess her condition. "After evaluations, I was told my baby had HLHS and would need heart surgeries early in life,” Roshawn shared. “Prayer kept me strong. My family encouraged me not to give up because God has the final say.”
HLHS, or hypoplastic left heart syndrome, is a rare congenital heart defect in which the left side of the heart is underdeveloped. Babies born with this condition typically need three major open-heart surgeries within their first few years of life to survive. Trinity was born with only two functioning heart chambers, while a typical heart has four. The left side of her heart, including the aortic and mitral valves, was severely underdeveloped, and her main pumping chamber was on the right. She also had Shone’s variant, a condition causing multiple left-sided obstructions affecting blood flow to her body.
“My pregnancy was monitored closely, with frequent follow-up appointments with my OB/GYN and MFM to keep an eye on my baby’s heart condition," Roshawn recalled.
On December 2, 2018, Trinity was born at Children's Memorial Hermann Hospital, weighing five pounds and one ounce. Delivered by C-section, she was transferred to the hospital’s Level IV neonatal intensive care unit (NICU).
Although Roshawn couldn't hold her daughter right away, she still remembers that precious moment. “She cried a little bit when she was born, and she came out with her eyes open. She was my angel.”
The First Two Surgeries: A Race Against Time
Just three days after her birth, Trinity had her first open-heart surgery, the Norwood procedure. This initial surgery is crucial for babies with HLHS to reroute the blood flow, allowing the body to receive oxygenated blood. After this procedure, Trinity spent two months in the NICU, facing challenges like arrhythmia, but her family and medical team stood by her every step of the way.
At 6 months old, Trinity underwent her second surgery, the Glenn procedure, to treat HLHS. This surgery involves connecting the superior vena cava directly to the pulmonary arteries, allowing blood to flow more efficiently to the lungs for oxygenation. It was a critical step in improving her overall circulation and helped enhance blood flow to her lungs.
A Critical Turning Point
By the time Trinity was one year old, her situation became dire. Her only functioning pumping chamber—the right side of her heart—was severely depressed, and she went into heart failure. Trinity was no longer a candidate for the Fontan procedure, the third surgery commonly used to treat HLHS.
The options were to treat her heart failure medically, and prepare her for a possible heart transplant. “Transplant is always the last option,” Dr. Aggarwal explains. “For the next year and a half, Trinity’s heart failure was managed medically. She received high doses of diuretics, which help remove excess fluid from the body, keeping her heart rate low and her lungs dry. We monitored her closely. We were able to improve her heart function, and when she was 4 years old, we moved forward with the Fontan procedure.”
The Fontan procedure is the third and final surgery in a series for children with HLHS. It reroutes blood flow to reduce the heart’s workload, allowing oxygen-poor blood to bypass the heart and flow directly to the lungs. However, the surgery didn’t go as planned, and Trinity faced complications that kept her hospitalized for six months. Despite these setbacks, her mom never lost hope. "I cried and prayed. It was a lot to deal with, but I knew Trinity was a fighter," Roshawn said.
A New Hope: Growing the Left Side of Her Heart
In a remarkable turn of events, Dr. Aggarwal noticed something extraordinary during one of Trinity’s follow-up echocardiograms—the left side of her heart had grown slightly. This growth opened up a possibility that hadn’t been there before. After consulting with the cardiovascular surgery team, they made a bold decision: they would attempt a biventricular conversion, a highly complex surgery aimed at promoting growth in the left side of Trinity’s heart.
This procedure, performed in February 2022, marked a turning point in Trinity’s journey.
The surgery team promoted increased blood flow through the left side of the heart to encourage its growth. The goal was to create a heart with two functioning ventricles—one on the right and one on the left—each performing its normal role. Achieving this often requires multiple surgeries or interventions to enlarge the left ventricle and its associated structures, enabling it to support normal blood flow to the body. This approach is used when the left ventricle is small but has the potential for growth and functional circulation.
The surgery was successful in encouraging the left side of her heart to function better, but Trinity still faced challenges, particularly with the narrowing of her aortic valve.
The Final Conversion to a Four-Chamber Heart
By July 2022, the left side of Trinity’s heart had grown enough for surgeons to perform her fifth heart surgery: a full conversion to a normal four-chamber heart. This complex procedure involved reshaping her previously abnormal heart structure into a typical four-chamber system.
The surgery, often called a “full conversion,” was nothing short of miraculous. For a child once facing the possibility of a heart transplant, Trinity now had a fully functioning four-chamber heart.
Dr. Aggarwal expressed his amazement after the surgery: "It’s incredible. Her heart is working so well without a transplant," he said. "Outcomes like this are truly remarkable."
The Road Ahead
In March 2024, Trinity underwent her sixth heart procedure, an aortic valve replacement. An artificial valve was implanted in the aortic valve position and opened up the entire area on the left side of her heart, allowing it to function like a completely new heart, enhancing her heart's efficiency.
Today, Trinity is not just surviving; she is thriving. She still has regular checkups with Dr. Aggarwal and takes medications to ensure her heart continues to function properly, but her transformation is nothing short of remarkable. “She no longer needs oxygen support,” Roshawn says proudly. “She loves going to school and adores her teachers and friends. She likes to sing Disney songs and run around. She’s my heart warrior.”
Words of Encouragement
For families going through similar journeys, Roshawn shares these words: “Never give up. There were many times when I was afraid, but I prayed. God has the final say. Hold on to your faith, and lean on the support of family and friends. I am deeply grateful to her doctors and the entire heart team; Trinity is here today because of them, too. We never lost hope.”
Now, at five years old, Trinity is living proof that miracles can happen, one heartbeat at a time.
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Learn more about the Children’s Heart Institutes at Children’s Memorial Hermann Hospital »