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Date: 13 Oct 2003
Time: 13:40:39 -0700
Remote Name: 126.96.36.199
Liam got back from the cath lab about 1 1/2 hours ago. We went to see him and he has a little breathing tube in his nose, but that should be coming out shortly. He did well. His heart went into an atrial flutter but the doctor did a quick tap on his sternum and it put his heart into a normal sinus rhythm.
Dr. Baffa came out and gave us an update on what they want to do. They saw that the tricuspid valve is allowing for regurgitation (which is what Dr. Harmon has been seeing all along), and this is the reason for the very large right atrium. Dr. Baffa likened this to Ebstein's Anamoly, which is where the tricuspid is abnormally displaced below where it should be. However, Liam's tricuspid is actually much better than that, and it actually is in the right place. She said his heart is very large and takes up much of his chest cavity, but he still has room for his lungs. Because of the heart's large size, she said that Dr. Norwood is likely to perform the right atrium placation (cut a piece out to make it smaller).
Also, some kind of fix to the tricuspid will be performed, though they may not know what exactly they'll do until they see the tricuspid in surgery. Dr. Baffa also said that the large VSD is positioned in the posterior portion of the septum and the aorta is in the anterior. Therefore, it may be a long stretch to get the extension out to the aorta (as in a Rastelli procedure). If they can do this, though, Liam's heart should be able to be fixed back to a normal heart anatomy.
However, they may not be able to do it. If that's the case, Dr. Baffa said that Dr. Norwood may elect to do a procedure to combine the ventricles together. This is his normal fix for Hypoplastic Left-Heart Syndrome. Although Liam doesn't have this condition, his procedure for this may be the way to go to give Liam a good strong heart. Dr. Norwood will be making a decision tomorrow morning, either before his first procedure or just after. Therefore, we should know what the game plan is tomorrow morning.
Liam, Heather and Chris