Friday, April 21, 2006

 

News About Surgery


So here is the plan so far...
It isn't a complete and detailed plan just yet, as the meeting between her cardiologist and the cardiovascular surgery team was just this morning.
The big picture explanation consists of a combination of cath lab and surgery.
Sophia will need to have surgery to replace the pulmonary artery conduit which currently has the pseudoaneurysm. This is basically a repeat of the last surgery minus the unifocalization.
The other problem is the narrowing of the branches of the PAs. Her cardiologist is still measuring, but I think the narrowing is around 2mm on each side. It is possible to stent these narrow areas in order to widen them allowing more blood flow to the lungs. However, both sides are fairly complicated to repair.
The placement of the stent on the left side is not complicated necessarily by the anatomy. However, it is difficult to get to in the cath lab and will likely be stented in the operating room during surgery. However, the surgeon may decide to repair it by other means if it seems more advantageous to do so once they are in there.
The right side is complicated by the location of the narrowing in relation to where the arteries branch off. This repair will be much more complex and will involve a combination of two stents placed parallel to one another, each going down the separate branches. I know this is difficult to understand without a picture, I will try to explain. When you imagine the part of a "Y" where the trunk ends and it forks in opposing directions, this is where the narrowing is located. In the cath lab, two catheters will be fed through the artery, parallel through the trunk of the "Y" and then dividing, each going up the separate side branches. Stents will be placed partially up each side extending through the narrowing. The stents will then be expanded side-by-side in order to open up the narrow part from 2mm to approximately 10-12mm. There is a reason it requires two stents as opposed to one. If one were used there would be the possibility the stent would only go down one side and block off the other. With two, both sides are preserved.
So, this would all play out something like this. Sophia would go into the cath lab and have stents placed in the right side as explained above. She would be allowed to recover a day or so, and then would go into surgery to have the conduit replaced. While in surgery her cardiologist would place a stent through the incision into the left pulmonary artery.
There is a possibility she would do both at once, but it is unlikely. However the suggestion was made that she could do the cath in the morning and go into surgery while still under anesthetic from the cath. This is unlikely because it would cause her to be under for a very long time. And though the anesthesiologist said that was not a problem her cardiologist and ourselves both think it is an unnecessary risk.
At this point, none of this is scheduled. But, we are looking at late May most likely.
I will post more as I know more.
Comments:
I have a lot of trouble understanding the mechanics of Sophia's heart surgery, all I know is she goes to sleep and the surgeon performs a mircle to keep her alive so I can love her a while longer.
My heart breaks and the tears flow freely when I think there is a chance I could lose my precious dolly.
I love her so and I know she loves me, she gives me kisses and sleeps cheek to cheek on my shoulder. She has been and will always be the love of my life.
Mike and Patty are the most devoted and loving parents I have ever seen and they share her so freely with me. I can't thank them enough for allowing me to love this little girl as much as I do.
 
WOW they can do just amazing things with these stents! We were also told they might have to use 2 stents on Evan, turned out they only used 1. I understand what you are explaining, I think! Evan's PA was opened from 3mm to 8mm. We continue to say our prayers for Sophia, mom and dad too! Thanks for the update.
 
Michael, you do a great job of explaining what's going to happen, so you must understand it all much more than I do! I will continue to pray for Sophia.
 
Hope all goes well, and always enxious for updates, our prayers continue on Sophia and your family's behalf.
 
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