Visit with Dr. Hanley

Dad's log:  Dr. Hanley stopped by and had a good discussion with us.  Hailey had nine MAPCAs which were successfully attached to her pulmonary artery.  The flow study found pressures of 28 (I assume this is mmHg) and they needed to be 25 to complete the full repair.  Approximately 35% of kids who undergo this procedure do not have the right pressures to complete the full repair during the initial operation.  She will still have low oxygen saturations probably about what they were before her surgery (approximately 85%).  So she will still be blueish.  She will still have symptoms of congestive heart failure but thanks to the shunt, they may be slightly improved.  They expect her recovery to be around 14 days with about 7 of those to be spent in the cariovascuar intensive care unit (CVICU).  She was on the heart/lung machine for quite a while and it sounds like that may prolong her recovery. 

So while the unifocalization of the MAPCAs was an important step, the repair of the pulmoary atresia has not been completed.  The shunt they inserted will ensure blood flow to the newly combined MAPCAs which will enable them to grow.  As they grow, the pressures in her heart will decrease.  Somewhere between 3 months to three years later, another heart surgery will be performed to remoe the shunt, insert a pulmonary valve/conduit and close the VSD.  This will then complete the repair.  If the full repair were completed prematurely while heart pressures were still high (her current condition), it would result in high blood pressures in the lungs which is is harmfull (pulminary hypertenson).  So Hailey will likely require a future catheterization procedure like that completed on Monday to determine when pressures hae dropped to a safe level.  With the unifocalization already out of the way, the next surgery would likely be of a shorter duration.  While a lot of the things we were hoping would happen today did not, today's surgery preserves her MAPCAs and supplies them with the blod necessary for them to grow larger. 

We expect to see Hailey in about 45 minutes.  She is in the CVICU now and they are getting her settled and the doctors are completing a turnover from the surgery.  We are a little aprehensive to see her after all of this.  Even our limited experiences after her birth probably won't quite prepare us for her post heart surgery condition.  But after not seeing her for 15+ hours today, we definately want to use this chance before we head back to the RMH.  They dont have room in the CVICU to room in with her so that will have to wait until she is moved to a recovery room.