Thaddeus Update 66

Thaddeus' procedure went well.

Our saga began last night. Thaddeus was not allowed to eat after midnight, so we kept him up until 11:30 so that he could eat something as late as possible. However, since they wanted us at the hospital by 6:30, that meant getting up at 4 something or another. There were certain drivers on the road this morning that made sure I was wide awake for the drive down. By 7:30, Thaddeus was being prepped for the surgery. They took some blood and Thaddeus wasn't crazy about that, but when he found out there were stickers involved, he perked right up! The surgeon talked about the procedure with us. The big take away was that they really wouldn't know what they were going to do until they had a chance to look around during the catheterization. That is where they insert dye into his bloodstream and then use an x-ray video to see where the blood goes. The surgeon told us that the most likely scenario would be that they would see that the left pulmonary artery is as small as they think it is and that they would put in a stent. He did not think an angioplasty was at all likely. Also, while they were in there, they were going to check and see if the fenestration could be closed. The fenestration is a bypass valve that the doctors put in at the last surgery. It allows some of the blood to go back into the body without passing through the lungs. The downside to this is that it keeps his oxygen saturation level down a bit. The upside is that it keeps the pressure on his pulmonary system lower. This stops fluid from pooling in his chest and around his heart. They would do this by checking the pressure levels in his system and then basically inflating a balloon in the fenestration and watching what happened. Our surgeon thought that if he put in a stent, he would NOT close the fenestration at the same time. However, I have signed many waivers that proclaim that medicine is not an exact science. To prove that fact, most everything that the surgeon predicted would happen, did not. The left pulmonary artery is quite a bit smaller than the right, but it is larger than it was at the last catheterization. Also, the pressure level in his system was just fine. So, they did the balloon trick and then checked his pressure level. It did not change. Hmmmmm, thought our surgeon. He decided to have a consult with the cardiologist. The two of them looked over the numbers. With the fenestration blocked, Thaddeus' pressure was unchanged, his flow was good, and his oxygen saturation jumped from 85% to 95%. (Normal is 99% to 100%. Thaddeus once got up to 90%.) Based on that, the two of them decided that now was NOT the time to do a stent. It is possible that Thaddeus will still have to have one put in in the future, but the longer they wait, the bigger he gets, the better it is. However, it is also possible, they will never need to do it at all. The LPA (Left Pulmonary Artery) is clearly smaller in appearance, but we care about function. As long as the function is in acceptable parameters, the feeling is not to add more hardware than is necessary. Now this part is cool. When they put the fenestration in, they actually put sutures in to close it again. So, while they did cut him open a bit, they were able to basically yank the thread and close the hole. (I am sure it was a bit more complicated than that, but it was not a full bore open heart surgery.) In addition, while they were in there, they found out that Thaddeus had a bit of a hernia probably caused by the drainage tubes from his previous surgery, so they cleaned that up as well. They only real negative of the entire thing was that a different surgeon was needed to close the fenestration and he had an emergency to deal with. As a result, things took longer than anticipated. Thaddeus went in around 8 am and came out around 2 pm. Obviously, they can't tell us what the emergency was, but I got the sense it came out ok, so we didn't mind waiting longer if it made some other parents have a better day.
We will stay the night while they monitor Thaddeus. (We are two rooms down from one of our other visits.) Assuming all goes well, he will get to go home tomorrow!