ECHO & Surgery Appt.

We met yesterday with part of baby Newman's care team.  Since his arrival date is 'tentatively' scheduled (assuming he doesn't have his own agenda) the cardiologist, cath lab, etc. should be ready for him.  We also met with one of the Mercy neonatologists, very helpful as now we know the general sequence of events for the morning...if all goes as we are hoping we will hear his first cry sometime shortly after 730 am, he will get whisked next door for his umbilical lines and prostaglandins and if he is stable we get to see him (and maybe even hold him!!) before he goes to the NICU. 

For the next few hours he will either get settled into the NICU or will go to the cath lab to get a bigger atrial septal defect (enlarging the one they made in Boston even more now that there is easier access to his heart).  Ross will be at his side as much as possible and I will be arguing with my 2 nurses that there is really no reason that I have to lay in a bed until I can move my legs when hospitals have wheelchairs (I could be wrong but pretty sure that's why someone came up with that idea, right?). 

The first big surgery is called the Norwood Procedure.  There are several varieties but at Mercy they do the classic Norwood (the newer procedures don't have any better data for them really).  It will likely be sometime between day 4 and 14, mostly depending on how stable he is and OR scheduling, etc.  In this surgery they enter the right atrium (top blue chamber) and use a piece of tissue graft to make a new aorta out of the old pulmonary artery (where the stitching is) so that it can be used to carry blood to the body.  Then they put in a temporary shunt (BT shunt) that will take some of the used blood from the body to the lung to get oxygen.  It returns the same way as normal through the pulmonary veins (in this picture the little red vessels).  Lastly they cut out any of the remaining atrial septum so the blood can freely move across from the red to the blue side so some of the blood that goes back to the body has oxygen from the lungs in it. 

When we asked about if they thought the stent could be retrieved at this time (it is now stuck in the bottom blue chamber)...the answer was "that will take some more thought" - good.  It is REALLY scary if people tell you they know exactly what to expect from something - you can't be confident what to expect from anything!!  After his heart surgery he will most likely go the the pediatric intensive care unit (with the bigger sick kids) as that is where they routinely do the post-surgical care.  He will have a ventilator, some chest tubes and a bunch of IVs at that point.  He will [obviously] still be adorable!! 

We also had a follow-up ECHO and though the blood flow in the pulmonary system looks like not quite as much blood is getting across the atrial septum hole as it was a month ago overall it still looks much better than it did at the beginning of November. 

We have 1 more ECHO the week before, and 1 more ultrasound to measure his weight.  In the meantime, I will be having twice weekly non-stress tests to make sure his heart rate is responding well to stress.  I am guessing he will do fine--Addy has been poking him for 8+ months and he usually kicks back :)