Cath Results

Lynnea's heart catherization went fine -- she was extubated shortly after being moved up to the PICU, and has been doing OK since then. She briefly needed some oxygen support, but we promptly weened her off from it again, and she's holding her own. That's the good news.

As for the results of her cath, they were not very encouraging. First there is her pulmonary vein. Over the past few months, Dr. Gruenstein has been doing an experimental "cutting balloon dilation" procedure on a monthly basis in order to try to open up Lynnea's left pulmonary vein. The expectation was that her vein would open up nicely during the proceedure, and then close back up within a month or so for the first three or four times that the procedure was done, and then after three or four times, the hope was that it would begin to stay open on its own. Today was the fourth time that Gruenstein dilated her pulmonary vein. The good news was that it had not narrowed as much in the past month as it had after the previous attempts. The bad news was that today Gruenstein was unable to open it up much more than it already was. Before today's dilation, the diameter of her vein was 2.7mm. He managed to open it up to 2.9mm. This was very discouraging news, and Gruenstein said that he believes it may be time to give up on this procedure and talk about trying to repair the vein surgically. Even though it might be possible to repair the vein surgically, the procedure to do so is very difficult and risky, and would need to be repeated fairly often (probably every couple of years), so it is an option that we have desperately been hoping to avoid.

The other discouraging news was that, from what Gruenstein could tell while he was in the cath lab, it appears than there is no blood flow at all to Lynnea's left lung. While Gruenstein offered a few possible explanations for this, he admitted that he was only guessing at the reason for it, and said that he doesn't know the cause. This causes a few extra challenges. It means that, without good blood flow to both lungs, she is still definitely not a candidate for the Glenn procedure. Even more importantly, if they can't restore blood flow to her left lung sometime in the near future, chances are good that she will ultimately lose her left lung, making a heart/lung transplant necessary at some point (which decreases her chances even further of ever finding a donor, and increases chances of rejection if she were to find a donor).

It still sounds like she will not have surgery until January, but we haven't discussed it specifically with Dr. St. Louis yet, so we don't know for sure. She needs another open-heart surgery to replace her B-T shunt, and probably have some more repair work done on her aorta.

Since she seems to be doing pretty well after her cath, we are hoping to be discharged tomorrow sometime.