January 18th
Erica was sleepy all day today. She also had another echo done today. As the cardiologists were looking they also pointed out some key words in describing what they saw to each other. Lucky enough for me, I've studied the heart and lungs so much that I was able to understand what they were talking about.
The sole purpose of this very long echo (2+ hours), was to get confirmation on the pulmonary veins (the veins leading from her lungs into her heart carrying oxygen rich blood [there's 4 of them] of their locations and size (stenosis). It had confirmed that Erica has two veins leading into the left atrium (the right location) and 2 veins leading into the right atrium (the wrong location). One of Erica's veins is the size it should be, 2 are slightly stenosis'ed and one is very stenosis'ed letting little to no blood flow through.
A rough idea on how her veins look:
O o .
right size (1 vein) slightly stenosis 'ed (2 veins) very stenosis 'ed (4th vein)
The plan so far, unless Dr. Ian Adatia (a cardiologist from California that also has offices in Edmonton and Winnipeg and specializes in pulmonary hypertension) says otherwise, is to only do one surgery for now. This surgery would be to close the PDA with a staple and do the lung biopsy as previously discusses. They would then wait (as long as she could handle), to continue with the surgery to relocate the pulmonary veins back to the left atrium.
There was no talk of any other surgeries for her ASD, the "shelf" in her aorta, or the stenosis veins. If once they closed the PDA and realised that they needed to move the veins asap they would do so. They would much rather wait with moveing the veins because they're so small and delicate, they don't like to be touched/disturbed. Once they are bigger they will be able to work with them better, although waiting wouldn't make the veins more resiliant or tougher. They also are hoping that with closing the PDA, that it will lower the pressures, with lowering these pressures it will make it safer to put her on the heart and lung machine for the bigger surgery. Apparently when the heart and lung machine is used, the pressures raise to an unhealthy , but tolerable level, tolerable as long as the patient doesn't have high pressures to begin with. With Erica's pressures and the pressures the machine will give her it wouldn't be safe at all.
They would still like to do surgery ASAP. So it would be as early as tomorrow or friday.
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