Catheterization #3

OK, so how to explain... Well, I won't go into all the back story of Ruby's heart conditions (most of you know it anyways) but in case you don't know she has ToF, PA, VSD, and MAPCAs. This was repaired back in November by connecting her little MAPCAs to a conduit (a cadaver's main pulmonary artery) in order to make somewhat normal bloodflow. The little MAPCAs, which now compose her branch pulmonary arteries (PAs) have a couple issues, as discovered in this cath. We knew something was up because during her last ECHO they found the pressure in her right ventricle to be a bit high. At the time they told us it could be one of three things: specific narrowing in her branch PAs, narrowing in her conduit, or that her branch PAs were not growing. It turns out to be the first option, which is the best of the three.

There was a spot on her left branch PAs that had narrowed and so it was ballooned in order to expand it...most of you know this procedure as an angioplasty. She will eventually need a stent put in but for now, she is too small. She also has an issue in her right branch PAs. They are apparently curving in an odd way. This is also a contributing factor to the increase in pressure in her heart, but not much can be done about it during the cath. This will have to be repaired during her next open heart surgery. Unfortunately the ballooning that they did do didn't really help bring her pressure down much. Hopefully, it will prevent it from increasing.

A very dopey Ruby in pre-op thanks to some meds

The good news: her conduit looks great! This means that she most likely won't need another heart surgery for another 1-2 years! This could change of course, and she will have to have an ECHO in a month or 2 to monitor the pressure in her right ventricle. But for now, I will take the good news and be happy about it. The doc told us that of the patients he's seen with Ruby's specific set of defects, she is one of the better cases...so that's great to hear.

The reality is that Ruby's heart and PAs will never be normal or functioning with perfect capacity. She will always need repeat caths, ballooning, eventually stenting, and so forth. But she is doing very well right now and has a wonderful quality of life. Except for the moments when we are stuck in the hospital of course! So overall things are going well...and hopefully we can get out of here tomorrow and back to our version of normal :)