Cath Lab

Wheeling off to surgery...

First post in some time, sorry!  House is crazy and there doesn't seem to be time to do any of the things we would like to do, let alone the things we have to do.  Muriel will be a full three months old this Friday.  Time has really flown by.

I like to wear socks on my hands

Megan and I are sitting in the waiting area of the Hope Children's Hospital catheter lab.  Muriel left us about an hour ago, and is at this moment being prepared for a procedure meant to test the pressures inside her heart and major vessels.  If you read the older posts you might recall that her first operation involved banding her Pulmonary Artery to regulate (limit) the blood pressure to her lungs.  She has been growing, which is expected to have the effect of tightening that band as the artery itself gets bigger and the band does not.  A catheter is being run from her inner thigh (actually just heard moments ago that they failed to get it in her leg, and instead have entered through her neck!) up a major artery to her heart.  Through this tube they will be able to draw blood for tests and insert instruments for pressure tests.  They will also perform a test by injecting a dye that they will use to trace flows within her heart and lungs.  This is outpatient surgery, and we are being told not to worry - routine stuff.  With any luck we will be leaving later in the afternoon and home for dinner.

Chubby is good!  Over 11lbs now.

The results of the lab work will be used to gauge her readiness for the next major surgery - the "Glenn" procedure.  Because Muriel effectively has only a single pumping chamber in her heart steps must be taken to reroute her plumbing and create two closed loops.  At the moment her circulatory system is more like three closed loops, with her heart at the center.  Each pump mixes blood returning from the body with blood returning from the lungs, to create an oxygenated mix (pink rather than red) that is just enough for her to get by.  As she gets bigger that will no longer be enough.

The Glenn is the second step in a series called the Fontan Procedure, which will eventually create the two closed loops from three.  In the Glenn the large vein returning blood to the heart from the upper part of the body (Superior Vena Cava) will be connected directly to the Pulmonary Artery, in other words directly to the lungs without passing again through the heart.  There should be just enough pressure, even after passing through the capillaries in her brain and upper body tissues, to get that returning blood through the lungs for oxygenation before returning to the heart for another circuit.  Amazing!  This should raise her oxygen saturation enough to let her continue for perhaps as long as a year before the final procedure.  It will also reduce the blood pressure in her lungs, which were not designed to handle the pressure that the rest of the body normally endures.

We are of course very anxious to hear about scheduling this next major surgery.  On one hand we want her to be as big as possible for the surgeons, and of course the older she is the better she will tolerate all of this poking and prodding, i.e. put it off as long as possible.  On the other her lungs shouldn't be asked to endure "systemic pressure" any longer than necessary and of course it would be nice to have this behind us.  I'll post an update as soon as she comes out - we will be sitting with her in recovery for six hours as she is monitored before release.

Just heard that she is doing fine in the middle of their pressure tests.  Sleeping soundly with no unexpected issues so far.  Back soon!

Happy girl!