Christopher's cardiac catheterization was yesterday. We arrived at the hospital bright and early (7:30 a.m.) and he was checked in and changed into pink striped hospital pyjamas. Then we did a fair bit of waiting around until just before 9:00, when the anesthesiologist and the anesthesia resident showed up to escort us to the cath lab. We handed Christopher off at the door of the room and as the door was swinging closed, we heard a chorus of female voices cooing at him -- the two nurses, the cardiologist who did the procedure, and the cardiology fellow all know him and seemed quite happy to see him!
We were shown to the same waiting room where we waited during his two surgeries. It was a bit tough to sit in that room again. I think we both felt our anxiety mounting as soon as we walked in. However, we had both brought lots of reading material to distract ourselves. They had told us that the procedure would take 3 hours but they were done in about 2 1/2 hours. The cardiologist came to talk to us afterwards. She told us that there were actually two adjacent areas of narrowing ("re-coarctation") right at the site of his original surgery. The artery which feeds his left arm branches off the aorta right around there and due to the narrowing, the flow to his arm was so reduced that the cardiologist didn't initially realize that the branching vessel was actually that artery: it just looked too tiny. So it's pretty amazing that his arm is functioning so well and growing normally, given that it doesn't seem to have been receiving normal blood flow for the last little while. Fortunately they were able to improve the flow there so the arm is getting much more blood flow now.
They used a tiny balloon on the end of the catheter to dilate the narrowed areas as were able to reduce the gradient (the difference in pressures across the narrowed spot) to negligible levels. Of course the measurements were taken immediately after the dilatation, while he was still under anesthetic, so she warned us that the end result might not be quite as good as that.
They also had a look at the area of the patch on his aorta and they said the flow looks great through there. The puckered area has flattened out and blood is flowing nicely.
The cardiologist told us that she can't say for sure whether he will need another catheter in the future to dilate the narrowed spot again. She said, "maybe he will and maybe he won't." It depends a lot on whether that area grows with him or stays how it is right now.
After the procedure, he was taken to the Recovery Room and we got to go see him fairly soon afterwards. He was still pretty dopey and really fussy, much as he was after the anesthetic for his cardiac MRI a couple of months ago. However, he had a really kind nurse who helped us to settle him and he quickly woke up and starting acting like his normal self -- which is to say that he started eating and was much happier after that!
I think I mentioned before that one of the risks with a cardiac cath is of a clot forming in the femoral artery, which is the spot in the groin where the catheter goes into the body. They were initially worried that he had a clot because the pulse in his left leg was very weak. However, that settled down within the first hour and the blood flow to both his legs remained good throughout the rest of the time in the hospital. They think the reduced pulse at first was because the artery was spasming from being irritated by the catheter.
Christopher and I stayed overnight at the hospital. We were on 5-East, which is the ward where he stayed following his PICU stays after both surgeries. We got to see a bunch of the great nurses that took care of him during the summer. They were all thrilled to see how much he's grown and how well he is doing.
We had a pretty good night - the usual inpatient sleep pattern, which is that you finally get the baby to sleep when it's time to check his blood pressure again! However, we both managed to get a few hours of sleep.
Christopher had an echocardiogram this morning to check on things. We got a basic report from the cardiology fellow, who told us that things look 'good' and the gradient across that narrowed spot has been reduced by a little more than half. Apparently the goal with dilatations is to get the difference in pressures down by half, so that's considered a good result. There is, however, still some gradient (more than the negligible numbers they got initially), and we're not clear on whether that was to be expected, nor about what the next steps will be. My guess is that we'll be back to doing regular echos to watch that spot while he grows, but we'll know better when we get to talk to Christopher's regular cardiologist in the next week or so. (He was away the past two days so we didn't get a chance to see him while we were there.)
We got home this afternoon. When we went to pick up Katie at her baby-sitter's, she ran to see Christopher and asked him (in this sweet high-pitched voice that she uses with him), "Chrissifer, how's your heart feelin'?" It was pretty sweet.
Thanks to everyone, far and wide, for your prayers and positive thoughts this week. We are so grateful.
Right before the procedure: it was naptime and he fell asleep on Daddy's lap.
Right after he woke up, in the Recovery Room. Still looking a little sleepy.
And a few more, from earlier this week:
Oh my goodness...they are so so sweet!
Posted by: Dee Light | 12/10/2011 at 09:17 PM