Today, we had Tehilla's appointment with our cardiologist, Dr. Golander. She had an echo to check on the size of her pulmonary arteries. There has been no progress. They have not grown.
Tehilla did not have the "normal" Stage 2 surgery, the Glenn at 6 months because her pulmonary arteries were too small. Instead they replaced her Sano shunt from her Norwood surgery, with a BT shunt of 5 cm. This was done, so that she would not outgrow her Sano shunt from her Norwood and crash. They also specifically put one of the biggest shunts to increase the pressure on her pulmonary arteries and force them to grow.
That last part has not happened. We have waited and pushed off the Glenn in the hopes that her pulmonary arteries would grow on their own. It has been 6 months since her BT shunt surgery and we can now respectively say that her pulmonary arteries are not growing. This pushes her to an "irregular" case of HLHS.
Because we have seen that her pulmonary arteries are not growing and have given a reasonable amount of time for it to happen, we can not expect that they will grow. So, there is no sense in waiting any longer. We are going ahead with the Glenn surgery with this added problem. Dr. Erez, our surgeon will open Tehilla's pulmonary arteries and put a patch on them to be the necessary size.
We are doing a heart catheter this Monday, November 3rd. There they will double check that the pressures in her heart are within the right range. As well, they will be checking to see that the branches of the pulmonary arteries, that are inside of the lungs, are the right size. We get admitted to the hospital on Sunday, where they will do blood tests and put in an IV. We then go home to sleep and come back for the catheter on Monday by 7:00am. They will keep her overnight and barring any complications, we should be released on Tuesday.
Dr. Golander drew us two diagrams. The first is just a sketch of the Glenn surgery. The second is the pulmonary arteries and the lungs. You can see the branches of the pulmonary arteries there.
Here is a video to quickly explain the Glenn:
I can't say that overall, we are feeling good about today's appointment. We are going into a heart surgery in a less than ideal situation. We have complete confidence in our surgeon and cardiologist, and will remind ourselves to think positively.
Please have Tehilla in your prayers that all outcomes should be great. Nothing less than great.
Tehilla bat Shoshana.