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post-op day 2

The surgery went well considering all that was done. They did fix the coarctation as well as the AV canal defect. The operation lasted about 7 hours, and it was about 12 hours until we were able to see Faith again. It basically all went according to the plan that was laid out in the previous post. There were a couple of things that the found once they started the operation that needed to be fixed. The first was that the right ventricle walls were not relaxing open the way that it should. Some of the bundles of muscle tissue had connected both the posterior (back) and anterior (front) walls. The surgeon cut the bundles allowing the right ventricle to open fully. This wasn’t a big deal for the surgeon when he saw it.

The second unexpected event during the course of the surgery was when the amount of tissue available to reconstruct her mitral valve. As the surgeon went fix it, he had to get creative in order to do so because there was a lack of the muscle tissue. Typically there are three different classifications for mitral valve leaflets. Unfortunately, Faith’s didn’t fit into any of the classifications. Because of the original condition of the valve, we knew there was going to be some amount of leakage (murmur). Mild leakage is not necessarily an issue, moderate leakage can be controlled with medication, and severe leakage may require another surgery. At this time, the leakage is moderate, and they are monitoring it. The doctors are anticipating Faith needing blood pressure medicine to help. Other than those unexpected events, everything went well.

Last night, things started to get a little crazy. Faith is a very strong little girl, but sometimes it works against her. All day yesterday she fought everything that was trying to help her. That caused her blood pressure to be all over the place. They finally had to give her vecuronium, which is a paralyzing agent. She is also on versed, morphine, epi, dopamine, and a few other meds that I can’t remember. Basically she is as “happy” as she can be considering all that she has been through.

Between the hours of 9 and 11:30 pm, it was all hands on deck. The surgeon and cardiologist both had to come in. There were three doctors and four nurses working on our baby. The goal was to find what was causing her blood pressure to go all over the place. The Cardiologist did an echocardiogram and both he and the surgeon intently watched the monitors looking for something that would explain what was going on. What they found is that even though her heart was keeping the same amount of beats per minute, the rhythm changed ever so slightly. In order to keep the same rhythm, they have her hooked to a pacemaker. This is not permanent. Once she is able to handle it on her own, they will disconnect the pacemaker.

The other concern last night and today is her lungs. She does have pulmonary hypertension, and her lungs are very sick. The left upper lobe was somewhat collapsed yesterday, but has been getting better. There is still a lot of fluid surrounding the lungs and they are very wet from the two major heart surgeries that she went through. They will not be able to start getting rid of the fluid until her blood pressure is stable. She will receive more lasix to assist with the removal of the fluid once she is consistently stable.

Her blood pressure has been cooperating a little. It still needs to be about 10 points higher. In order to keep her blood vessels dilated and her lungs relaxed, they have put her on Viagra. Originally they were going to use straight nitric oxide. They also lowered her core body temperature from 37.4 degrees Celsius to 36.2 degrees Celsius. Both these adjustments seem to be working. Hopefully she will continue to allow these things to help her and she wont fight them; which she should considering the fact that they have her pretty well conked out.

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  1. Kathy Marchione
    September 5th, 2009 at 20:51 | #1

    She and all of you are in my prayers.

  2. Sandra Aponte Salazar
    September 6th, 2009 at 20:51 | #2

    Hello,
    I found you through Twitter, where I read your posts. I am now following you on Twitter. Our three-year-old Brianna passed away last Sunday of Pulmonary Hypertension –one of the most severe cases they had seen at Texas Children’s Hospital. Here’s a link to a news release (my husband is a Houston Police Officer)
    http://www.piersystem.com/go/doc/1827/320977/
    Our Brianna was able to donate her heart valves and, in the midst of our sadness, it makes us happy to know another child and another family will be happy.
    I rejoice in your daughter’s recovery because it looks like she went through some of the same things: the Flolan, the Viagra, the drops in blood pressure.
    I pray she will make a full recovery and lead a happy life with you.

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