PDA Ligation

For those requiring more information, and for us, as parents who will someday want to remember all these things we were told, here's the full deal on Charlotte Amalie's surgery. (No, we still don't know what we're really calling her...)

CA went into surgery at about 10:00 AM. Peter and I met with the CHOP Pediatric Cardiac Surgeon this morning, went over what would happen in the surgery and signed the consent forms. The rest of the team came in about 45 minutes later (they got stuck in traffic coming out from CHOP).

Basically the surgeon made a small (everything dealing with CA is small...) incision on her left side, just under her armpit. He was able to spread her ribs and move the lung to access the duct in the heart. He clipped a titanium clip around the duct and voila! surgery is successful. The whole thing took 30 minutes. The surgeon came out, told us everything went well and that the duct was a moderate size. We did surgery at the perfect time.

Before the surgery, he told us that the biggest risks were damage to a nerve that runs to the voice box (remember when Julie Andrews sued her surgeon year ago? Yeah, he cut that nerve.) The nerve wraps itself around the duct, so it has to be stretched so that a Julie Andrews result does not occur. The stretching of this nerve irritates it, so patients are hoarse for a few weeks. Seeing as how Charlotte Amalie does not make noise, we weren't too worried about the stunted speech aspect. The other risk was tearing of the duct. Apparently, the duct is the consistency of "wet tissue paper" so you can see how it might tear. The surgeon reassured us that this was unusual, telling us that he has done over 400 of these PDA Ligations and has only had it tear 3 times. When it tears, they just sew up the duct and close it with a stitch. How you sew up wet tissue paper, I don't know, but he seemed to think it was no problem at all.

So by 12 noon, we had oo'd and awe'd over our little post op patient enough that we felt we could leave her. She has a chest tube in to allow for any drainage and that should come out tomorrow. I called and spoke to her doctor at 6:00 PM and he said that she was still sleeping. She really does take after her mother :) She's currently taking some medication to keep her blood pressure down and she's still pretty much sedated. Because of that, they've had to play around with her vent settings a lot and that means taking a lot of blood gas draws to make sure the vent settings are correct. So even though she didn't need a transfusion during surgery, she might need one tonight to make up for the blood that they used to check blood gas levels.

(Transfusion for surgery? No. Transfusion for lab work? Heck yes!)

Thank you all so much for your support. Your prayers, your meals, your offers to watch Caleb, have all helped make this scary day much more doable. So we thank you. We thank you all.