Tomorrow marks another big day for our Sweet Little Valentine Lydia. She will be undergoing her first open heart surgery in the morning and will have a BT shunt placed and possibly a band around the pulmonary artery. Up until now, the blood going to her lungs has been regulated by the ventricular septal defect (VSD) which is the opening between the 2 ventricles and allows for mixed blood to go to her lungs. Lately her VSD has been varying in size and causing her to become more and less stable with her O2 saturations which is why she has had such a difficult time recovering after her last surgery. We knew this day would come when her heart would take center stage. While most tricuspid atresia babies have this done in the first few weeks of life, Lydia’s VDS had been large enough to allow good blood flow to her lungs and she had been relatively stable. Hopefully, this will buy us 6+ months to allow Dr. Jennings and Dr. Foker to continue working on the esophagus and get her stable enough to come home. The consensus after last week’s meeting with all her doctors, was to allow the esophagus growth to continue a couple weeks after recovering from the shunt and that she would tolerate the thoracotomy procedures better with the pulsatile blood flow going to her lungs that she will continue to have after the shunt versus the passive blood flow that she will have after the Glenn or Fontan surgery.
A Blalock-Taussig Shunt or “BT Shunt” is used to help increase blood flow to the lungs in babies born with defects that obstruct blood flow to the lungs. The surgery entails opening the chest through the sternum and placing a Gore-Tex tube form the innominate artery to the pulmonary artery. This is a palliative procedure, meaning that in most cases the final repair will be done at a later date.
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