Image from Cath yesterday

This is one of the images we were given from Wren's cath. It shows the obstructions that are causing most of the problem. The large fuzzy black shape on the lower left is Wren's left ventricle. The surgeon has drawn two lines across the space leading out of the ventricle and the aortic valve. This shows that the sub-aortic obstruction which makes the width of the outflow tract much narrower (5.6mm) than the valve (10.2mm).

The longer line shows the potential valve opening from the base of the leaflets but those two bumps under the longer line should not be there. Instead, that should be a straight channel going into the valve.



Again, above the valve there is a pinched hourglass with a big bump - a supra valvular obstruction. This also needs to be fixed.

Both these obstructions make Wren's left ventricle work much harder than it should. His LV pressure was 150 under sedation and Dr J estimated it would be in the 200's when active. He also suggested that Wren's mitral valve was not really exhibiting its true motion due to the high LV pressures. They recorded slightly increased pulmonary pressures too (new to us) which shows the mitral valve is also stenotic. Right now, data suggests it is mildly stenotic but the obstructions further down make this hard to evaluate and the doctors were cautiously suggesting it is moderately affected.

This leaves the surgical team a lot to talk about - definite work on sub-aortic stenosis and 'above valve' stenosis. Probably improving of aortic valve since OHS is happening anyway and possible dealing with mitral valve - decision to be made later.

This adds 20lbs

Wren is coming OUT! They did not do any ballooning. The obstruction is under the valve so that indicates OHS. Crap but what we expected.

Here I am dressed for surgery.


Here are Josh and Wren on the Twin Falls hike on the weekend.

Wren is in surgery

We are waiting in the Family Resource Center at Childrens. Wren went into the cath OR at 8am. The procedure should take 2 hours with 1 hour being the cath intervention and 1 hour going in and out of general anesthesia.

They allowed me to walk him into the OR and hold him until he was sedated with gas. I picked Root Beer flavor but when I kissed him bye bye the gas did not smell like root beer to me.

Nurse Amy from CICU is our nurse today. It was great to see a familiar face although everyone is a bit familiar after our last dry run.

This morning we spoke to Dr Jones regarding the likelihood of his doing the ballooning of the valve and arch. He seemed more circumspect about doing it that I had expected. He said that they will only intervene if the valve or coarc are the dominant factor in the LVOT and arch gradient. There are expected to be many components but it is not considered worth the risk of a ballooning for a minimal improvement.

He is going to call us during the procedure to let us know whether they are going ahead with a ballooning. If not, it should indicate that the sub-aortic area is the major issue.

They are also going to see whether the mitral valve is involved (terror in my heart). Surely, I hope not. The echo has not shown trouble in the past but I guess we need that confirmed.

More soon.