The Moser family loves the Ohio State University Buckeyes, but uniquely also bleed a bit of maize and blue, too.

That's because Chloe Moser, 5, has had two heart catheterizations and four heart surgeries at University of Michigan Health C.S. Mott Children's Hospital.

Her parents, Casey and John, credit Mott with saving their daughter's life.

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This past August Chloe was back in Ann Arbor again for her fourth major surgery. Although Mott has become a bit of a second home for the Mosers, this trip was tinged with anxiety as the Mosers prepared to work with a different pediatric heart surgeon, Vikram Sood, M.D.

"We were super nervous. I was worried until the day of the surgery, when we met Dr. Sood, but he was fantastic," Casey said. "He had a great bedside manner. We were comfortable with the plan for the surgery, and comfortable afterward. My husband and I feel like it was in God's plan that it happened the way it happened and that we had a fresh set of eyes looking at her [during the operation]. We feel really blessed."

For his part, Sood says it's important to him to make families as comfortable as possible before an operation.

"I've been taught by my mentors at Michigan Medicine how sacred the bond between a surgeon and a family is—how important it is to help a family be as comfortable as possible entrusting their child to our care," he said. "I put myself in a family's shoes and act and behave in a way that promotes confidence in me, my team, our system and our approach."

Preparing for surgery

The lead up to the surgery was a whirlwind.

Chloe has a bicuspid aortic valve and Shone's Complex, a congenital heart condition that essentially means the left-side structures of the heart are small, so they typically require continual repair work throughout childhood. She had a subaortic membrane resection in 2018, and the family knew a follow up procedure would be required at some point because of the nature of her condition.

"She had a recurrence of the obstructing ridge underneath the aortic valve," explained Sood. "Additionally, her aortic valve had two leaflets rather than the 'usual' three leaflets. As a result, the valve didn't open well, leading to an additional area of resistance within the outflow tract. Chloe's heart was working extra hard to pump blood across this area of obstruction."

Chloe regularly sees a pediatric cardiologist closer to the Moser's Perrysburg, Ohio, home, Jeffrey Moore, M.D., who has monitored her aortic valve for the last two years. During her checkup in July, Moore said he thought it was time to return to Mott for the follow up surgery.

Moore called Mott and the Mosers were surprised to learn Chloe would receive the surgery in just two weeks. The timing worked well, though, because it meant the family was able to self-isolate to prevent exposure to COVID-19 for a full two weeks. If the surgery had been later, Chloe would've been back in school, making isolation that much more difficult.

At the end of August the Mosers made the now-familiar trip, again, to Ann Arbor. Chloe brought with her a special stuffed animal, a little lamb, which has now accompanied her to every one of her surgeries.

During the surgery, Sood was accompanied by fellow pediatric cardiothoracic surgeon Richard Ohye, M.D., and was assisted with OR imaging from pediatric cardiologist Thor Thorsson, M.D.

The team was hopeful Chloe could avoid a Ross procedure and undergo resection of the obstructing muscle ridge alone.

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A Ross procedure is an aortic valve replacement that involves replacing the aortic valve with the patient's own pulmonary valve and the patient's pulmonary valve with a pulmonary valve from a deceased donor.

"Because the donor valve won't grow with a child's heart, the Ross procedure is nice to do when the child is as big as possible." Sood explained.

During the operation, the team assessed whether Chloe's aortic valve needed to be replaced and determined a full replacement could wait until she's older.

"She'll probably need a Ross down the road, but if she could be 10, 12 or 15 years old when that operation takes place, the durability of the repair will be better," Sood said.

The Mott team and the Moser family were all very pleased with the outcome. Sood kept close contact with Chloe's cardiologist at home about her progress.

"I try to contact the referring providers right after surgery to let them know how it went," Sood said.

"In Chloe's situation, we were able to get a great resection of recurrent ridge and did not feel that a Ross procedure was warranted at this time," said Sood.

The Mosers were relieved the Ross procedure wasn't needed this time, and took comfort in knowing that Ohye, head of pediatric cardiovascular surgery, was assisting during the operation.

Recovering after heart surgery

Chloe bounced back quickly. The surgery took place on a Tuesday, and she was able to go home on Friday—a stark contrast to her first surgery at two-and-a-half months old that necessitated a 16-day stay in the hospital.

"Her recovery is a testament to Chloe's strength, the intensive care unit team at Mott and how good they are at helping kiddos after an operation," Sood said. "She advanced really quickly, and on the morning of the fourth day after surgery she was ready to go home."

Casey was thrilled with this result because it meant the family could take Chloe's little brother, Connor, to his first day of preschool together. While at school drop off, Chloe had a chance to see her teachers and friends before she went home to continue her recovery.

Chloe missed her first day of kindergarten while in the hospital, so Casey and John commemorated the day with a homemade sign on the door of her hospital room. Chloe missed the first few weeks of school to recover from her surgery. When it was time to go, she got a special escort to her first day.

Casey said, "Chloe's best friend's dad is a state highway patrolman, and he wanted to do something special, so he organized a parade escort with the local fire department, police department, EMS and more—there were 15 departments total. When we pulled into her school, her kindergarten class was outside with signs, chanting her name. It was really cool to see the community rally around her and support her."

Chloes first day of Kindergarten was today and since she was at @MottChildren recovering and missed the real first day all of the area PD's and FD's escorted her to @OtsegoK. Can't thank everyone enough for their support, what a great day! #CHD @AdamKoch_Otsego pic.twitter.com/5uuXDLiyNV

— John Moser (@Moser_Farms) September 13, 2021

From Sood's perspective, this community support is what makes the Mosers so special.

"What has struck me about Chloe and her family is that they have such a remarkable support system behind them," he said. "There's a toughness about Chloe even though she's a petite kindergartener, and that's a product of her family and her community's response to Chloe's congenital heart disease. Her community has rallied around her and is clearly a source of incredible strength."

Sood, and the rest of the Mott team, continue to cheer Chloe on from afar. The Mosers are active on social media, which helps Sood stay up to date with her process.

"Her recovery seems to be going great. The follow up ultrasound imaging suggests that the decisions we made in the operating room were sound," Sood said.

Giving back to Mott

Every year, the Moser family gives back to help other Little Victors through an annual fundraiser called "Chloe's Corner."

This year, the fundraiser focused on adding books, coloring books and crayons to Mott's Giving Library cart that comes around and offers books to young patients. The Mosers focused on in-room entertainment in part because the communal playrooms at the hospital are currently closed because of COVID-19.

"We know how much that stuff gets used and how appreciated it is by parents trying to entertain their child while staying in the hospital," Casey said.

Although Chloe is healthy at home for now, the Mosers know this won't be their last trip to Ann Arbor.

"We started at Mott, we feel comfortable at Mott and we'll continue Chloe's care there as long as we can," Casey said.