Lily Cater, who had her second birthday yesterday, has had an operation for pulmonary atresia — a life-threatening condition linked to underdevelopment of the heart — repeatedly rescheduled at Birmingham Children’s Hospital.

The condition, which affects about three children a year in Britain, requires an intensive- care bed for post-operative recuperation. However, pressure on the Birmingham unit has meant that the 19 beds available have been taken up with children at immediate risk of death on each occasion.

The parents of Lily, who is not expected to live beyond her fifth birthday if she does not have the operation, said that it was appalling that the NHS could not provide enough beds for such crucial surgery.

Michala Cater, of Bradford, West Yorkshire, said that it was immensely frustrating to know the hospital had the expertise, but not the facilities, to carry out the operation.

“We could understand it being cancelled a few times but seven is ridiculous,” she said. “Lily is getting bluer and bluer by the day. I just want them to operate and make our little girl better.” Mrs Cater, an accounts manager, added: “It’s agonising for all of us. Every time we get a date for the operation we get mentally prepared, pack our bags and make all the arrangements and then it doesn’t happen.”

Lily was first due to be operated on a month ago. She was listed as an urgent case after her parents, who initially took her to Leeds General Infirmary, approached doctors in Birmingham for a second opinion.

Mrs Cater and her husband, Paul, a construction worker, have founded the Lily Cater Cardiac Trust in the hope of raising funds to improve research into the condition. Patients with pulmonary atresia suffer from a lower level of oxygen in their blood — normally about three-quarters that of a healthy person — due to underdevelopment of arteries linking the heart and the lungs.

As a result, the heart has to work twice as hard. Lily also has a hole in her heart, problems with feeding and breathing, and poor circulation.

The complex operation, which involves inserting a plastic tube to connect an unused artery to create another channel for blood flow, and closing the hole in her heart, has a 20 per cent fatality rate.

Birmingham Children’s Hospital NHS Trust said that the organisation had extended its apologies to the Cater family for the additional anxiety caused. It said that all relatives of a child awaiting heart surgery were always given warning of the possibility of delays.

“Cancelling surgery is not something we do lightly or for any reasons other than to accommodate emergency cases or when the unit is full,” an official said.

“Of course, we understand that this is very stressful for Lily and her family but it is impossible for the trust to guarantee that any operation will not be cancelled at short notice, and all families waiting for heart surgery are told this.

“However, every effort will be made to ensure that Lily’s operation proceeds as soon as possible.”

The British Heart Foundation said that only 49 children in Britain were born alive with this rare defect between 1985 and 1999.

Children with pulmonary atresia require lifelong follow-ups by a cardiologist to check how their heart is working. These children risk developing infection in the heart’s walls or valves, known as endocarditis, before and after surgery.

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