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Date: 16 Apr 2004
Time: 15:36:31 -0700
Remote Name: 22.214.171.124
Liam is finally done with his cardiac cath. They took him about 11:30am and we got to see him around 4:30pm. It was a long wait, but they did a lot while they were in there.
Dr. Murdison performed the catheterization. They checked the pressures in the chambers of his heart - they were a little high, but not high enough that they were concerned. He decided to test and then close off Liam's azygos vein which was working as a bypass to Liam's hemi-fontan procedure, putting deoxygenated blood into oxygenated blood. He also saw an extra, small superior vena cava, which is sometimes present in babies with congenital heart disease. Like the azygos vein, this extra SVC was providing a bypass to the hemi-fontan system that they put in. He closed off the extra SVC also. Dr. Murdison noted that the regugitation from the tricuspid valve was not as bad as they thought it might have been from the echos they were doing.
They also saw a "communication" between the right ventricle and the main pulmonary artery. This was allowing a small amount of blood to flow through an area that Dr. Norwood had closed in a previous procedure. The effect of the hole, though, is to allow some extra blood to get to the lungs to become oxygenated...and that's not a bad thing. When the procedures were complete, they noted that Liam's oxygen sats had gone up, but whether this is a permanent thing remains to be seen, since he's on more oxygen right now.
Dr. Murdison also mentioned that Liam's lungs might have a few problems with oxygenating blood, but we'll have to see whether the changes they just made are making a difference to him. We're hoping we'll understand the next steps after they have a chance to study that data they retrieved in the cath lab and after we have a chance to speak with Dr. Baffa.
Right now, Liam is slowly waking from the anesthesia. He's not very happy and is in some pain. They've given him some painkillers to try to calm him. Because of the redirection of blood flow, he has some swelling in his face...like he did with the hemi-fontan before, though not nearly as bad. If he looked like he did 10 rounds in the ring after the hemi, he's more like 5 rounds this time. His poor eyelids are really swollen. They took him into the step-down unit to monitor him constantly, but, as per the norm with caths, he didn't need a visit to the ICU, so that's definitely good. Unlike his caths in the past, he didn't have any problems with atrial arrhythmia so they didn't have to shock him with the paddles. Also unlike his prior cath, he didn't have any post-op breathing problems.
So at this point, Heather and Chris are relieved that everything seems to have gone well with the procedure and it seems that they have all the information they planned to get in order to make a decision for the next steps to take.
Thank you all so much for your support and prayers. Liam appreciates them very much.