I’m ashamed to admit that I really didn’t know exactly how the heart worked before Rudy’s heart defect was diagnosed. I knew that it pumped the body’s blood to where it needed to go but beyond that I really didn’t give it much thought and, truly, took the heart for granted. Even after Rudy’s diagnosis, I had to reread the “If Your Child Has A Congenital Heart Defect” booklet we received from the cardiologist a few times to wrap my brain around what exactly was going on in our son’s heart and still couldn’t quite grasp the complexities of it all. As we prepare for the 2nd of Rudy’s three heart surgeries, I thought it would be helpful to explain (as best I understand) what’s going on in Rudy’s heart and what will be asked of it in this next phase of his treatment to kind of put things in perspective.
Rudy had his monthly cardiology appointment with Dr. Harake yesterday. The symptoms surrounding his pneumonia diagnosis last week really weren’t addressed specifically but the issue of his general health is key as we approach his scheduled heart cath on October 21st. Should he get sick, the cath will have to be postponed so we are praying for a speedy recovery and good health from here on out – especially as we head into flu season. In regards to his heart, everything looks about the same and we will see Dr. Harake one more time in mid-October before we head down to UCLA for the heart cath. There is evidence, however, of the possible narrowing of Rudy’s aorta – a condition known as “Coarctation of the Aorta” which makes it hard for the blood to flow through this artery to the lower part of the body. This is something Dr. Harake has been keeping an eye out for and could be happening now because the aorta is not growing with Rudy. Dr. Harake and the team at UCLA will verify to what degree the aorta has narrowed during October’s heart cath and, if needed, perform a balloon angioplasty to open it up.
A diagram of Rudy's Heart from his last cath
So, here’s my simplified explanation of where we’re at and what’s coming…
In a normal heart, the blood low in oxygen flows from the upper body back to the heart through the SVC (Superior Vena Cava) into the right side of the heart (right atrium and then right ventricle). The right side of the heart pumps the blood into the pulmonary artery which takes it to the lungs to get fresh oxygen. After the blood is refreshed with oxygen, it returns to the left side of the heart (left atrium and then left ventricle) where it is pumped to the aorta and taken to the body’s general circulation.
Because Rudy doesn’t have the left side of his heart, he is currently known as a mixed-blood baby. His oxygenated and non-oxygenated blood flows through the shunt that was attached in his first surgery (Norwood) – see diagram above. The Glenn procedure will begin the process of separating his blood. In the diagram above, you’ll see that the SVC that is bringing the blood from the body back to the heart is located in front of the pulmonary artery at a 90 degree angle. In the Glenn, the SVC is severed from the heart and attached directly to the pulmonary artery. Essentially, we’ll be relying on the blood from the upper body to “drain” it’s way directly to the lungs instead of being “pumped” to the lungs through the heart. The success of this procedure is dependent on good lung health as well as little blood resistence so the blood is allowed to drain into the lungs. (Rudy has been treated with two Pulmonary Hypertension drugs for the past 6 months to reduce this resistance)
I was rereading the history of one of our HLHS friends who passed away last year after his Glenn and his mom described it as “his body couldn’t adjust to the recirculation of the blood”. This was helpful to me because it reiterated the fact that we are completely rerouting the circulation of Rudy’s blood in this process…asking his body to do something that it wasn’t intended to do. We are asking A GREAT deal of his little half of heart and surrounding, compromised lungs! And so, it motivates us to pray…to pray fervently and specifically in preparation for the Glenn…whenever it happens. We’re doing all we know to do to keep Rudy healthy and strong for the Glenn but, ultimately, the success of this next big leap is out of our control. We pray for God’s continued protection and mercy AND perfect timing for surgery as we prepare to move forward.
We humbly ask you to join us in praying specifically for the things mentioned above…may our prayers weave a blanket of protection and comfort over Rudy that will prepare him and surround him in the weeks and months ahead. 🙂 As always, thank you…we are so grateful for you! Love and Hugs…
A late night trip to Michael's to use my 40% off coupon before it expired!
I think Rudy's just happy to be out of the house! 9-11-10