Of more immediate concern to doctors was the lack of a hole between the two sides of her heart, a defect that was causing blood and pressure buildup in the lungs.

“We felt that she was an extremely high-risk patient,” Armstrong, one of Mira’s surgeons, said.

So when Mira’s mother, Katie Larrison of Algonac, Mich., reached the 30th week in her pregnancy, doctors at Mott’s Congenital Heart Center decided in-utero intervention was necessary to improve the baby’s condition. Katie underwent an innovative surgery in December 2008 in which a team of University nurses and physicians, including Armstrong, created a hole between the left and right atria of Mira’s fetal heart.

Despite the risks — elevated by Mira’s Turner syndrome, a rare chromosomal disorder affecting approximately one in 2,500 females — the surgery was successful, with Mira boasting strong vital signs upon her delivery the following January. Acting quickly after the birth, Armstrong began implementing a plan that would involve additional procedures to carefully “re-route” the infant’s heart to allow her right ventricle to do the work of the faulty left ventricle for the entire body.

With special attention paid to Mira’s Turner syndrome, Armstrong and Jennifer Hirsch, also a pediatric cardiac surgeon at Mott, performed multiple minimally invasive procedures on Mira in an effort to improve the blood flow in her heart. Hypoplastic left heart syndrome can never be fully corrected, Armstrong said, though surgeries like this can improve heart function.

“We did newer, more innovative hybrid procedures to ‘re-route’ the blood going through her heart using stents and bands,” Armstrong explained.

Armstrong said she never expected to make medical history by becoming one of the first interventionalists in the nation to perform this series of unconventional surgeries on a developing infant, both pre- and post-delivery, and yield positive results.

But even after her successful procedures, Mira’s health still wasn’t 100 percent.

“(Mira) was on a heart transplant list for six months because the pressure in her heart and lungs was elevated, likely due to the severe former heart disease,” Armstrong said.

Six months later, though, Mira showed significant improvement as pressure normalized, bringing the Larrisons some much-needed relief as their daughter was removed from the transplant list.

With Mira back on track for her series of surgeries, Katie said she and her husband Jeremy were nervous as Mira underwent her next procedure at Mott, but said they were comforted by the preparedness of Mira’s medical team.

“(The doctors) would play out different scenarios,” Katie said. “There was always a plan. We always knew who was involved in her care.”

Armstrong said Mira may need another surgery around her third birthday. But for now, Mira’s life is steadily approaching normalcy.

“She’s much happier,” Katie said.

With an obvious tone of pride in her voice, Katie added that her daughter began to “scoot on her butt” when she was about 20 months old.

“She’s doing much better since her surgery,” Katie said. “(My husband and I) have been able to breathe more deeply.”