Thursday, September 4, 2008

Cath Day



After my bath on 9/2 (super happy boy)


Yesterday was a surprise to us. We came to TCH for Blake's pre-op cardiologist appointment which includes an echo cardiogram. Everything was going as well as could be expected, and Blake was such a good boy all day. Suddenly his oxygen saturation (sats) rates started to dip from his normal (mid 80s) to the 60s. Sats that low can be dangerous, so they decided to give him oxygen and admit him last night (most people's sats are in the 90-100 range, they like for babies like Blake to stay between 75-85). Blake and I stayed overnight, and it was mostly uneventful, he slept well (unless they were poking on him or trying to take his temp in the middle of the night) and his sats remained in the 80s all night.



On oxygen after my sats dipped (still a happy boy)

Update 1: As scheduled, Blake was anesthetized this morning around 8 am to undergo a heart catheterization procedure. They insert a scope up an artery in his groin and feed it all the way to his heart. Once inside they heart they insert a dye and take photos so they can have a very clear understanding of the shape of the heart before open heart surgery. The procedure should take between 3-5 hours. So far, he went to sleep very easily, and they had fully inserted the scope as of 9 am. They will now begin taking pictures.

Update 2: At 10 am, they have taken all of the pictures they need of his ventricles, arches, chambers, and branches. They are now looking for any collateral vessels that may need to be occluded (coiled off). Sometimes babies with congenital heart defect grow extra vessels to compensate for the lack of function elsewhere in their heart. They are looking to see if that is the case with Blake. If they find any, they will essentially tie them off so that they don't interfere with the re-plumbing they will be doing during the Glenn. If they don't find any they should be done with the procedure very soon.

Update 3: 5 minutes later, they just called me and said they are done. Dr. Ing is on his way down to tell me the results of the preliminary findings.

Update 4: Blake is out of surgery, and doing fine. Hopefully I will be able to see him in a few minutes. I just met with Dr. Ing, and he says exactly what we have been hearing is the case, Blake has outgrown his shunt. He showed me photos and you can see considerable narrowing of the shunt which is causing the decreased sats. Blake does have a considerable collateral behind his heart, but right now it is helping to oxygenate his blood, so they did not close it off. They showed the photos to Dr. Fraser who said he would try to tie it off during the Glenn procedure, but if he was unable to get to it, he would have to have another cath after surgery to occlude it. He is not getting as much oxygen to the right side of his lungs as he is his left, but again this is all due to his shunt being too small for his size. The good news is they said nothing they saw would push him to be an emergency case.

Update 5: He did great coming out of anesthesia, and I got to hold him and feed him just as he was waking up. However, his sats have continued to be much lower than we would like. Once they moved us back to his room, a team of cardiologists descended upon us, they immediately decided to give him an IV of fluids because they thought he may be dehydrated and that may be affecting his sats. They definitively declared that we would be staying in the hospital until his surgery one week from today.

More information on heart catheterization

1 comment:

natalie said...

Sending good good good thoughts to all. Love you.