Mid-surgery

Getting updates from the surgical nurse as the surgery progresses.  Her first update was basically to tell us that all prep was complete and that surgery was beginning.  She came in again about 30 minutes ago to say that the basic operation is complete, she is off the heart/lung bypass machine, and is being monitored for another hour at least.

Today's surgery consisted of:

• Closing (permanently) the malformed tricuspid valve
• Widening (permanently) the existing ASD (Atrial Septal Defect) , to allow the oxygenated flow from the lungs to bypass the now closed tricuspid valve
• Banding the Pulmonary Artery to regulate the blood pressure in the lungs.
• Leaving (permanently) the existing 6mm (!) VSD (Ventricular Septal Defect) , to effectively create one large pumping chamber
• Connecting leads for use with an external pacemaker, in the case that she shows signs of Cardiac dysrhythmia

All is complete, and the monitoring is to ensure that the band on the Pulmonary Artery is correctly regulating the pressure to the lungs.  They may have to adjust it (tighter or looser) depending on the pressures they are measuring.  This band will be removed in a later procedure (BiDirectional Glenn Operation).  Unfortunately the external pacemaker was required, and is now regulating her heart rate.  We are told this is temporary, and should be able to be removed during her recovery, which may last two weeks or longer.

The steps above are the first stage of the Fontan procedure which will result in a single ventricle heart, which will pump to both the body and the lungs by itself.  The lungs will receive the blue de-oxygenated blood directly from the body, and return the oxygenated blood to the heart as before.

The nurse just visited again as I was writing this, and all is now complete.  They are closing her chest and moving her to the PICU (Pediatric Intensive Care Unit) for continued observation, then to her own room in Hope Children's Hospital, which is connected to Christ Hospital.  We have to wait another two hours before we can see her.  All is well so far!  I'll post another update when we are settled in tonight.