Walking around downtown Little Falls, Minnesota, Paula DiVincenzo knew she and her husband, Joseph, didn’t exactly fit in. 

“We’re Italians from New Jersey,” Paula says, laughing. “We stuck out like a sore thumb.”

For a couple who lives in the shadow of the New York City skyline, the idea of traipsing through small-town Minnesota probably never entered their imaginations. But in the summer of 2023, that’s exactly where they were, with the visit to Little Falls just one more surprise in a yearslong series of events that had upended the DiVincenzos’ lives.

In January 2020, Paula was diagnosed with breast cancer. She had a bilateral mastectomy to get rid of the disease and three reconstructive surgeries. But the cancer returned in 2021, and she underwent treatment again. The DiVincenzos already had a daughter, Bianca, but they knew their family wasn’t complete.

“We also knew that [because of the cancer treatment] another pregnancy would be really difficult for me and for the baby,” Paula recalls. “So we froze our embryos with a plan to pursue surrogacy.”

Paula’s second go-round with cancer treatment was a success, so she and Joseph began looking for someone who could help them complete their family. Their search led them to Little Falls, where “we found our dream surrogate,” Paula says. On October 21, 2023, the DiVincenzos’ son, Joey, was born just down the road at a hospital in St. Cloud.

Joey’s birth went according to plan; the moments immediately afterward did not. Paula and Joseph learned that their newborn son had two congenital heart defects that would need to be repaired as soon as possible.

“There was just so much thrown at us so quickly,” Paula says. “We were like, ‘What do we do now?’ Luckily, our doctor in St. Cloud referred us to someone who could help.”

And so, just a day after being born, Joey was transferred to M Health Fairview Masonic Children's Hospital, where pediatric cardiothoracic surgeon Pranava Sinha, MD, was ready to take action.

Complex care for a tiny heart

As co-director of the Pediatric Heart Center at Masonic Children’s Hospital, Sinha leads what he describes as “the only one-stop solution for children’s cardiac care in Minnesota.” The center—which is fueled by generous philanthropic support from the Gougeon Innovation Fund in Pediatric Cardiology, John Bass Chair in Pediatric Cardiovascular Health, Summer’s Wish Pediatric Cardiology Innovators Fund, and Andrew David Sit Foundation Innovators Fund, among others—revolves around the idea of comprehensive yet very personalized care for each infant or child, he says.

“We provide the full spectrum, from prenatal care to taking care of newborns and children, and then helping them into adulthood,” says Sinha, who holds the John Bass Chair in Pediatric Cardiovascular Health at the University of Minnesota Medical School. “So we have anything that a patient like Joey might need.”

In Joey’s case, the idea of a heart defect wasn’t entirely a surprise. Prenatal ultrasounds of his heart indicated he might be born with a ventricular septal defect (VSD), or a hole between the two lower chambers of his heart. An echocardiogram immediately after he was born confirmed the VSD; it also revealed a second defect known as coarctation of the aorta (CoA), a condition where a child’s aorta is narrowed and makes blood flow from the heart to the rest of the body more difficult.

Typically, an infant like Joey will undergo corrective surgery just a few days after being born, Sinha explains. But in an effort to holistically treat the whole child, not just their heart defects, Sinha and his team carefully consider the bodywide impact of surgery before moving forward. For Joey, that meant an MRI to make sure his brain was functioning normally. It illuminated another unanticipated obstacle: a brain bleed that had to resolve before his heart surgery could take place.

“Open-heart surgery adds a lot of stress to the brain,” Sinha explains. “Had we done surgery, say, on day three, we might have made the bleed worse, and he could have had a stroke or major damage to his brain.”

Joey was placed in the neonatal intensive care unit, and Paula and Joseph began a tense, weeklong wait for their son to heal. In the midst of their anxiety, the couple found hope from the care team surrounding them, which included nurses, social workers, and even a therapy dog.

“The support was beyond our wildest dreams,” Paula says. “We were all in this together, and we knew that we were in the best hands.”

‘You would never know’

Joey’s brain bleed cleared up, and on Halloween, at 10 days old, he underwent surgery to fix the defects in his heart. Sinha says the goal was to repair both the VSD and the CoA in one go, but Joey’s heart had other plans. The CoA repair went off without issue, but the hole associated with his VSD was too close to a fragile heart valve, which at that age is the texture of “wet toilet paper,” Sinha says.

Not wanting to cause any additional damage to Joey’s tiny heart, Sinha skipped the VSD repair and recommended Joey have a follow-up surgery at six months old.

With one surgery down and Joey’s health in stable condition, the DiVincenzos settled in for what would become a five-week stay at Masonic Children’s Hospital. By the middle of December, Joey was healthy enough to travel, and the DiVincenzos made it back to New Jersey in time for their son to celebrate his first Christmas at home. Joey continued to get stronger, and in April 2024, he underwent a successful surgery in New York City to repair his VSD.

Today, Joey is nearing his second birthday and “doing everything a toddler his age should be doing,” Paula says. He loves books, running around, and playing with his very protective older sister.

“You would never know he had any of these issues,” Paula says in awe.

Beating hearts

Sinha says the prognosis for kids like Joey is great, though he will need follow-up care throughout his life. As he gets older and his heart outgrows its repairs, he may need an additional procedure to keep his heart beating strong.

With kids like Joey in mind, Sinha and his team are working to develop new ways to fix congenital heart defects that would allow repaired tissue to grow with children into adulthood—and therefore eliminate the need for more surgeries over time.

Meanwhile, the DiVincenzos are finding joy in the normalcy of life while working to help other families who are going through the same challenges they did. Not long after Joey’s second surgery, Paula and Joseph founded the Beating Hearts Foundation, which raises money to support families across the country affected by congenital heart defects and other cardiac ailments.

Earlier this year, a gift from the Beating Hearts Foundation provided financial assistance to more than 150 patients and families at Masonic Children’s Hospital for necessities like transportation, lodging, medication, and food.

“It takes a village when you’re dealing with something like this, and we realize there are a lot of families out there who don’t have the support we had,” Paula says.

As unusual as it sounds, Paula says, she wants every family to feel like hers did when they showed up at a hospital halfway across the country in a city they’d never been to with a newborn son in need of special care.

“We were so far away from home,” she says with a smile. “And still, we felt like we were at home.”

Make a gift to support the M Health Fairview Masonic Children’s Hospital Patient-Family Assistance Fund and the Pediatric Heart Center.