Frost and Shannon visiting Wren at Children's.
This morning Wren remains stable. I attended rounds in which the nurses, doctors and specialists reviewed his case and made plans for the day. They said he was stable, had mild jaundice (13.3 bilirubin) and was doing well with sats and vitals. Blood gases are still good (in the mid 7's). Their goal was to keep him relaxed and stable.
An EKG was done confirming his heart is doing okay now. I was there while they changed a diaper (he is very sensitive to wet diapers) and soothed him back to sleep with his sugar-water binky.
I met a second cardiologist who was very kind and attentive. For once there was someone to answer my questions and make sense of the process the team will go through in making the surgical decisions. He said that the conference tomorrow will come up with a recommedated surgery and it will likely be performed next week. The recommendation will take into account the desired biventricular outcome but will be limited by "what a surgeon can do". He said that while "you can tell a surgeon you want this and this done it won't work if he just can't do it" and that "different surgeons favor different approaches based on their best outcomes". He said they had done a norwood on a similar case in the past but it wasn't considered desirable.
He clarified Wren's diagnosis as:
1) Coarctation of the aorta. (discrete, distal to PDA)
2) Hypoplastic aortic arch (limited)
3) Hypoplastic aortic valve (borderline??)
I don't know whether we could move him to another hospital if they offer a different surgery - ie babies do well with a biventricular repair. I am going to have to talk to our other cardiologist and see.
Shannon
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