We had a busy day today. Sara, Jadon and I headed down to Sick Kids and arrived at 7:00. Our first stop was the blood-work clinic where we found out that the hospital had just switched over to a new registration system online. It caused some delays and I am sure that the IT department earned their money today! After blood was drawn, we headed down for a chest x-ray and then up to the Cardiology Clinic. Once there, we were ushered into a room to receive teaching about the operation and to meet some people involved in Jadon's care. We met the staff surgeon, a surgical fellow, an anesthetist, and research associate. A nurse practioner student was also in the room the entire time and she will follow Jadon into the OR as well. The nurse educator went through the whole surgery and post -operative process with us talking about what to expect. Overall, it was a busy but very informative day.
About Jadon's surgery: He will be having a Tetralogy of Fallot repair. I asked the surgeon how many were done yearly at Sick Kids' and he indicated that the surgical team likely performed around 50 Tet repairs yearly. After a VSD (hole between the two ventricles), it is the most common surgery they perform. What exactly is involved?
1. VSD Repair - Jadon has a rather large (about 1 cm) hole between his two ventricles. This means that his oxygenated and deoxygenated blood mixes. This hole will be patched up (with a material similar to polyester, apparently!)
2. Aorta Shift - Jadon has an overriding aorta, meaning it sort of lies above both the right and left ventricle and so gets blood from both. As they repair the VSD, they will shift the aorta so that it properly only gets blood (oxygenated) from the left ventricle.
3. Pulmonary Artery Stretch - the pulmonary artery (carrying deoxygenated blood from the right ventricle to the lungs to get the blood oxygenated) is thin, as is the valve between the ventricle and the artery. This will need to be cut and a patch put in to widen it. Given the tiny size of Jadon's valve, they likely will have to cut his valve away completely. He will then live without this valve with very little to no side effect until likely into his late teens or early twenties at which time he will need a valve put in.
4. Muscle Shave - as a result of his heart needing to
pump so much, Jadon's right ventricle is buff! This might be great for
biceps and abs, but not so much for the heart, as it causes problems.
Some muscle tissue will need to be shaved from Jadon's right ventricle.
As a result of Jadon's advanced age for this surgery (they typically prefer the surgery done around 5- 6 months of age), the pressure differences in Jadon's heart after it is repaired could be problematic. This is due to his stiff right heart and non- stiff left heart. To avoid complications from this pressure differential, they will also cut a small hole (a few mm) between his two atria, to act as a pressure relief valve. We were told that his body will likely depend on this quite a bit for the first several days, but that once the initial recovery is over, this little hole often heals itself, or if not, does not cause any further problems.
So there you have a layman's understanding in layman's terms what the surgery entails. Obviously, though it is a relatively common surgery, it is still quite complex. The recovery time depends on the individual patient, but we are to expect about a week in the hospital.
Thanks again for your prayers and support. 32.5 hours to go!