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Mandy is finally here, but it’s not all happiness and rainbows just yet. She has a serious medical issue in Outlander.

Jemmy’s birth was lonely for Bree in the Outlander series. It was also filled with fear and trauma. Nobody knew if Jemmy was Bonnet’s or Roger’s child. It’s only been at the end of Season 6 that the paternity was confirmed thanks to a mole.

Mandy’s birth was supposed to be different. Bree and Roger knew Roger was the father. This birth was supposed to be calm and peaceful. Well, as peaceful as childbirth can be. The only fear was supposed to be Brianna dying, because, hell, a lot of women died in childbirth in the past. They still do!

That’s not the way it’s turned out to be. Soon after Mandy’s birth, Claire noticed a serious concern. Mandy as patent ductus arteriosus. What is that medical condition?

Patent ductus arteriosus in Outlander explained

According to Mayo Clinic, patent ductus arteriosus is a heart problem present from birth. It’s when there is a persistent opening between two major blood vessels that lead to the heart.

This can lead to extra blood flow into the lungs, causing babies to breathe faster than normal. Some babies only have a small opening, so small that it can initially go undetected and won’t cause major problems. Others, like Mandy’s, are much more serious and lead to poorly oxygenated blood moving the wrong way around the system.

The heart muscle is weakened, and it leads to heart failure. Claire saw the signs, and she knew the only option to save Mandy was surgery. And it’s a surgery Claire couldn’t perform. To be honest, even in the 20th century, Claire wouldn’t be the one to do this. She was a general surgeon and not a heart surgeon.

It means Bree and Roger need to take their children to the 20th century. It’s the only way to save Mandy. Can they get there in time, or will the stones put pressure on her already weakened heart?

MORE: Did Jamie kill Richard Brown in the Outlander books?

Outlander* airs on Fridays on STARZ in the U.S. and on Sundays on W Network in Canada.