I spoke with our primary cardiologist at Children's who had been pondering Wren's case, data and second opinions since late last week. He has spoken with Dr Krabill who will call us later.
His final recommendation is to go into surgery anticipating a Kono procedure with mechanical valve replacement. Wren would be on Coumadin after that.
IF the surgeon sees that the valve is more robust than expected then he will revert to a valve-saving plan but that is not to be expected.
He believes that the surgery can be done successfully and well at both Seattle Children's and Stanford and that we should choose a place that has support for the family in case complications lead to a 6 week rather than 10 day hospital stay.
The approach is based on our definition of good result. I think it is Wren NOT being back in OR for 2-5 years....
If we do a myectomy below and patch above. (myectomy - valve small and thick and not normally formed.) Our expectation is that leaving valve will lead to level of disease and obstruction that is unacceptable. Given we are NOT recommending the Ross for 2 different reasons... we feel that the kono with mechanical valve is the approach of choice.