Our cardiology appointment did not go well and he has been readmitted to children's pending the results of a heart catheterization procedure which will probably be performed tomorrow morning. Based on the results of the cath they will either 1) do nothing, 2) Do some ballooning during the cath procedure or 3) schedule Wren for open heart surgery on bypass.
While x-rays, weight, BPs are all good the echo showed two areas of concern. Firstly, there is a moderate degree of turbulence around Wren's aortic valve (already bicuspid it is now showing signs of not opening fully and there was a differential of 30). This is my first pass at being told numbers for differential pressures so if someone can explain that 30 I would appreciate it.
The second, and more serious, problem is a high degree of turbulence across the aortic arch near the surgical repair. The area of teh repair looks good but about 2mm before the repair is an area of added turbulence. On echo there appeared to be another area of coarctation but it may have been an artifact of the image. In that case the turbulence would have been a result of the valve restriction... which is a bit unlikely being relatively far away to see turbulence, but possible. If there is another coarc in the position close to major arteries he may need open heart surgery since it is both close to the recent repair and the arteries. The very thought of going back to surgery so soon is just breaking my heart. He's no longer just a brand new baby - he's a little guy who has expectations of comfort and knows us...
So, here are the options:
1) They find the turbulence is not so severe and do nothing.
2) They find the turbulence is caused by the valve and is severe and balloon it.
3) They find the turbulence is caused by a blockage in the arch and balloon it.
4) The blockage is in the arch but they don't feel it is safe to balloon it and recommend OHS.
We are in the Giraffe ward if anyone needs or wants to call. Dr Leewin felt it wasn't safe to send us home before the procedure because Children with this prognosis can be "on a slipperly slope" with symptoms manifesting suddenly. Josh is at the hospital waiting to hear when the procedure will be.