Surgery Update

Lynnea has been in surgery since 7am, and shortly after 7pm they moved her out of the OR to the PICU. Dr. St. Louis replaced her B-T shunt with a larger one, and again did some repair work on her aorta. Things did not go as well as planned. For this procedure, Lynnea needed to be placed on the heart-lung bypass machine, which was planned from the beginning. Unfortunately, she had a difficult time coming off from bypass, and in the end was unable to come off successfully, and so was placed on ECMO (Extra-Corporeal Membrane Oxygenation -- essentially, a heart-lung bypass machine that can be used out of the OR -- she was on ECMO after her surgery last March as well). Her heart function looked pretty good, but her lungs were unable to handle the increased blood flow provided by the larger shunt. Dr. St. Louis is hopeful that a few days on ECMO will give her lungs time to relax and adjust to the increased flow; he's hoping to try to take her off ECMO on Wednesday. In the OR during the surgery, there was also a lot of bleeding that was difficult to control. While in the OR she was given five units of blood (that's about 2.5 times the amount of blood that normally flows through her body). Before moving up to the PICU, her blood pressures were much higher than Dr. St. Louis wanted them to be, so she was given medications to lower them.

Since moving up to the PICU, Lynnea has continued to bleed more than the doctors would like (she lost 400cc's in the first 40 minutes in the PICU), so she is continuing to receive a lot of blood products. The bleeding does not appear to be coming from any one spot, but rather a lot of oozing from everywhere that Dr. St. Louis stitched during surgery. Her blood pressures have also been unstable since moving out of the OR; they are now much lower than they would like, so they are adjusting her medications to try to stabilize them.