Just days after being born Louie Stokes was rushed to hospital for lifesaving heart surgery. It was discovered the major blood vessels attached to his heart were "plugged in the wrong way round".
To make matters worse he also had other congenital heart defects, including a hole in his heart which would need fixing. The decision was made to take the 10-hour old tot, who had a "blue tinge", to Bristol Royal Hospital for Children by ambulance for further tests and emergency treatment.
"It was fast talk about what the doctors were going to do to keep him alive right now, what they'll do in the future and how many surgeries he'll need," recalled his mum Lottie Stokes.
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"It was a very dark place for us both as parents to see our newborn baby being taken away so swiftly - and we still had our three-year-old son Dylan at home with my mother."
Lottie and husband Karl spent the first six weeks of Louie's life in Bristol where their son had two procedures to improve blood flow around his body. He then retuned for his first open-heart surgery two weeks before his first birthday.
On this occasion, surgeons used a synthetic patch to close the hole and a prosthetic valve to allow blood to flow around and out of the heart correctly. Lottie, from Cardiff, added: "He had his first birthday over there. We had a little party with cake, balloons and the nurses decorated banners for him."
He then had the same surgery repeated when he was four years old to replace the materials fixing his heart. "The worst part is saying goodbye to Louie at each operation. It's very much a case of handing over your beautiful, tiny baby to surgeons just hoping they'll look after them," said Lottie.
Heart defects are the most common type of anomaly that develop before a baby is born. Around 13 babies are diagnosed with a congenital heart condition every day in the UK - an average of 16 babies each month in Wales. These include defects to the baby's heart valves, the major blood vessels in and around the heart, and the development of holes in the heart.
For many of these children surgeons can currently perform open-heart surgery to temporarily repair the problem, but the materials used for the patches or replacement heart valves are not completely biological and cannot grow with the baby. This means they can be rejected by the patient's immune system which causes the surgical materials to gradually break down and fail in a few months or years.
A child might therefore have to go through the same heart operation multiple times throughout their childhood, which keeps them in hospital for weeks at a time, hugely impacts their quality of life and causes a lot of stress for the family.
But British Heart Foundation (BHF) professor Massimo Caputo, at the University of Bristol, has now developed the first type of 'stem cell plasters', a patch to repair abnormalities to the valve in the large blood vessel that controls blood flow from the heart to the lungs, and to mend holes between the two main pumping chambers of the heart.
The plasters are designed to be sewn into the area of the child's heart that needs repairing during surgery. The stem cells could then boost the repair of heart tissue without being rejected by the child's body. The plasters have the potential to adapt and grow with the child's heart as they get older, removing the need for repetitive heart surgeries and the many days at hospital recovering after each one.
There are around 200 repeat operations for people living with congenital heart disease every year in the UK. The technology could save the NHS an estimated £30,000 for every operation no longer needed, saving millions of pounds each year.
Massimo Caputo, BHF professor of congenital heart surgery at the Bristol Heart Institute, University of Bristol, said: "For years families have come to us asking why their child needs to have heart surgery time and time again. Although each operation can be lifesaving, the experience can put an unbelievable amount of stress on the child and their parents. We believe that our stem cell patches will be the answer to solve these problems.
"Our ultimate vision in the next decade is to create a paradigm shift in the way doctors treat congenital heart disease, by developing personalised stem cell and genetically-engineered treatments for the most complex of heart defects."
Lottie said Louie, who is now 13, doesn't let his heart condition stop him. "He lives and breathes football and enjoys playing it with his friends, but he does find it exhausting at times. With his t-shirt on you wouldn't suspect anything, but when you see his operation scars, you just think wow, this boy has been through a lot.
"We've always talked to Louie about his 'special heart'. He needs check-ups every six months, and we know he'll need a third open-heart surgery at some point, but we don't know when – it's a waiting game. It's not a fun game to play at all.
"Our heart is with Massimo, he truly is our hero. If Massimo's stem cell research can take away the need for other babies to go through these multiple surgeries, it would mean the world to families, so they don't have to go through this heartache over and over like we have."
Rhodri Thomas, head of BHF Cymru, said: "If successful, this new stem cell therapy that acts like a healing plaster could revolutionise the results of heart surgery for children and adults living with congenital heart disease. It could offer a solution that means their heart is mended once and forever in a single operation, preventing people from facing a future of repeated surgeries and giving them the gift of a happier and healthier life."
The BHF has awarded Professor Caputo nearly £750,000 with the aim to get these patches ready for testing in patients so clinical trials can start in the next two years, enabling more children and babies to benefit from the life-altering technology. The materials have already proven to work safely in animals.
The team is also in the early stages of developing other stem cell technologies using 3D bioprinting and gene therapy to one day be able to mend more complex congenital heart defects.
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