Alisa Barnard's heart was failing from causes related to her pregnancy when doctors at Intermountain Medical Center decided her best and perhaps only shot at survival was delivering the baby in the cardiac catheterization lab.

Tuesday, the 30-year-old Layton woman cuddled 2-week-old Lily Marie in her arms as doctors described the chaotic scene Nov. 10. The baby was delivered, using forceps, then cardiologist Dr. James Revenaugh threaded the world's smallest heart pump, the Abiomed Impella 2.5, into the pumping chamber of Alisa Barnard's heart to suck blood into the aorta for distribution to her body. That tiny pump, approved just a few months before by the Food and Drug Administration, gave her heart temporary support when it was too weak to pump adequately on its own, saving her life.

Once Lily Marie was safely delivered, the assembled multidisciplinary medical crew clapped and some of them wiped away tears of relief, they said.

Alisa and Paul Barnard also have three boys, ages 2 1/2 to 13. Not long before baby Lily was due, Mom started experiencing extreme fatigue and shortness of breath. She thought it was just the toll of the pregnancy; it was actually peripartum cardiomyopathy, a relatively rare heart failure syndrome that occurs in the final weeks of pregnancy or first few months after delivery.

When she went to McKay-Dee Hospital in Ogden for a test, her doctor was alarmed and she was transported by Life Flight to IMC in Murray, where she spent three days while doctors worked to stabilize her and come up with a plan to keep both mom and baby "safe and alive," said heart expert Dr. A.G. Kfoury.

Her cardiomyopathy had kicked off another potentially deadly condition, pulmonary hypertension, which reduces blood to the lungs and oxygen to the body and increases the already weakened heart's load. Going into the delivery, doctors figured things could go badly not only for Mom but for baby.

The medical team, led by Dr. Patrick W. Fisher, an advanced heart failure/transplant cardiologist, kept the plan fluid as her condition changed and doctors juggled various concerns. He referred to the night as a "nail biter."

Revenaugh described it as a "medical Rubik's Cube." Most heart pumps, for instance, require blood thinners — very dangerous during delivery, especially if there's a chance a Caesarean section will be required. So they took the baby first but prepped for insertion of the heart pump as they prepared for delivery. Meanwhile, her heart rate plunged then slowly rose as maternal-fetal specialist Dr. Flint Porter delivered the baby.

Even then, they gave Alisa Barnard only small amounts of localized anti-clotting agents at the site of the heart pump, which was removed three days later. Alisa Barnard now has an implanted defibrillator.

Barnard's heart remains weak, functioning at about 20 percent compared to the normal 50 percent to 70 percent. But when she arrived to have her baby, it was only 5 percent. They're all very hopeful that it will continue to recover, Kfoury said.

Awake the whole time, Alisa Barnard said she "relied on everyone's prayers and blessings" to see her through. And she's happy now to be back home with her family.

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E-mail: lois@desnews.com