He laughed, he seems like a great kid with a very good attitude, We love helping all these kids and kids like Anderson make it easy! He has an ASD so maybe Dr. Sommer can use another one of the Cardia devices that saleman Peter brought! Peter was very helpful in the cath lab while he was here for a few days and a lot of fun! (but definitely a salesman!)
Ingrid just sent word down that she will be beginning sedation on Iris in about 5 minutes, Kar-Mei Chan wanted to see the new IV insertion device that Ingrid is using so she will run over to OR soon to watch and learn, I will go to take photos!
Yesterday, amongst the cases that went smoothly, we had one unique case that was pretty scary for a while. 8 month old, Jafet Abisai Martinez Barahona (they always have long names!) had severe Pulmonary Stenosis—a pulmonary valve that doesn’t open all the way so that the pressure in the right ventricle is very high. The standard fix is to go in with a balloon catheter and expand it until it quite literally, tears the restricted valve open! Dr. Fuad Kiblawi and Dr. Bob Sommer did an excellent job doing just that, the valve opened, the pressure released, and then apparently the heart developed something called “suicide RV”! When I first heard the term I thought maybe someone had seen how I drive a motorhome! But of course it is potentially much worse than that. The way Bob explained it to me, the right ventricle develops as a much stronger muscle than normal because of the restricted valve. When the valve is opened, now there is no pressure build up and the muscle squeezes just as hard as it used to and all the blood is pushed out and the chamber basically collapses, now there is no opening left to receive new blood and the other side of the heart keeps all the blood. Jafet quickly became purple with a severe lack of oxygenated blood to the rest of his body. Dr. Chan worked feverishly to stablize the child and after injection of some “miracle drugs” to relax the overconstricting heart muscle, Jafet’s color came back. He was sent to PICU on a ventilator, paralytic drugs, pain killers, and muscle relaxants/beta blockers to give his heart a chance to get used to a new way of operating. Kar-Mei Mai worked especially hard and it was amazing to watch her wolf down two peanut butter and jelly sandwiches and two more slices of bread covered with chocolate crème! For such a petite woman, she sure ate a lot! Well deserved!
Just ran up to take some photos of Ingrid showing Kar-Mei how to put in central lines on Iris using a small echo locator to assist in making sure they are in the carotid artery. Its amazing how quickly Ingrid works, most of the people involved in surgery seem to work very quickly. I think I will go back to surgery soon to watch Iris’s progress, she has become something of a star for us, she thought she had no hope for a normal life and has been so elated that she now has a chance. We all pray that she will do well and cant wait to take photos after surgery so that we can compare her color with all the before surgery photos we have. Now, more sad news for the cath. Team and for Anderson, his ASD was so huge the closure device Bob and Henry Issenberg tried on him, at first looked good, but with a little tug, it popped loose. Not a good thing to happen when he coughed or something, so they pulled it out and decided he would have to wait until December or February when another team is coming to do more surgery—they will have to put a patch over the hole. Ok, up to OR to see how Iris is doing, Kar-Mei asked if I can get a close up of the heart during repair, she is a bigger girl, so I may be able to get a good shot. Hasta luego! Andreas
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