Another Heart Catherization with Unexpected Results

This morning's heart cath went fine from a procedure standpoint, but, like every cath that Lynnea has, the results were not exactly what Dr. Gruenstein was expecting. He went in expecting to take some pictures, and then discuss Lynnea's aorta with Dr. St. Louis to determine what they wanted to do about the remaining blockage in her aortic arch. Well, for now the discussion about her aorta has been placed on the back-burner, and the focus is on the more pressing issue of her left pulmonary vein. We were aware of the blockage in her pulmonary vein, but today's cath showed that the blockage is worse than expected, and worse than it was during the last cath. Lynnea only has one left pulmonary vein flowing into her heart, as opposed to two like most people. On a normal person, each pulmonary vein is about 5 millimeters in diameter. Lynnea's pulmonary vein had narrowed to 1 millimeter. Because of this narrowing, 90% of her blood flow was going to her right lung, instead of flowing equally into both lungs. Dr. Gruenstein presented us with a variety of options for how the pulmonary vein issue could potentially be resolved, each with significant drawbacks, and no guarantees of long term success. In the end, we chose to allow him to perform a procedure that he has never done before, that a cardiologist in Cleveland suggested (this cardiologist has tried this procedure a few times with some success, but it's still a bit experimental, so there's no long term data). Dr. Gruenstein used a "cutting balloon" (a balloon with tiny razor blades on it) to open up the pulmonary vein and place several tiny cuts on the inside of the vein. Then he used a regular balloon to open the vein up more. The results were positive, but he warned us that the doctor in Cleveland has found that the procedure needs to be repeated three or four times before the vein will remain open for any significant length of time. So, Lynnea will probably need to come back to the hospital on a monthly basis to have this done for the next few months. Due to all of this, she will not be having surgery on Sept. 21. That procedure has been postponed, hopefully until this pulmonary vein issue is resolved. Right now Lynnea is in the PICU, she still has the breathing tube in, but she should have it removed later today. There is a chance that she could be discharged from the hospital as early as tomorrow. I will update again when I have more news to report.