Cully Charles: Surgery Day

Thursday, October 31, 2013

Surgery Day - 5 PM

At 4:30 pm, Dr. Overman recapped the surgery for us. Cully did great! All the repairs look good and are structurally sound. There were minor bleeding issues and some electrical issues with the external pace maker that delayed the completion of surgery. His blood pressure was a bit low so he is receiving a higher than average dose of medication to regulate the BP. All and all things look positive.

The next eight hours will be critical for him. They will be gradually weaning him off the blood pressure meds and closely monitoring him.

2 comments:

JanelleNovember 1, 2013 at 6:01 AM
Cully is a strong little boy whose wrapped in the loving hands of his parents and family, the skilled hands of his care team, and the protecting hands of God, and in our thoughts and prayers. Much love!
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UnknownNovember 1, 2013 at 8:48 AM
Keep up the great work, Cully! Hugs to your Mommy!

Robin
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What is hypoplastic left heart syndrome (HLHS)?

Hypoplastic left heart syndrome (HLHS) is a severe congenital heart defect in which the left side of the heart is underdeveloped.

The heart's left side has the job of pumping oxygenated blood into the aorta, the large artery that carries blood to the body. In a child with HLHS:

The mitral valve, which separates the two left chambers of the heart, is too small or completely closed (atretic).
The left ventricle (the lower, pumping chamber) is very small.
The aortic valve, which separates the left ventricle and the aorta, is too small or completely closed (atretic).

Courtesy of The Children's Hospital of Philadelphia. http://www.chop.edu/service/cardiac-center/heart-conditions/hypoplastic-left-heart-syndrome-hlhs.html

What are the treatment options?

Surgical options include a three-step surgical procedure designed to create normal blood flow in and out of the heart, allowing the body to receive the oxygen-rich blood it needs.

Step 1: The Norwood operation. This surgery is usually performed within the first two weeks of life. It involves reconstructing the aorta and connecting it directly to the heart's lower right chamber (right ventricle). This allows the right ventricle to effectively pump blood to both the lungs and the body. After this operation, your baby's skin will still have a blue cast because oxygen-rich and oxygen-poor blood continue to mix within the heart. Once your baby successfully passes through this stage of treatment, the odds of survival increase.
Step 2: A bi-directional Glenn or hemi-Fontan procedure. This procedure is typically performed between 4 and 12 months of age. It reduces the work of the right ventricle by allowing it to pump blood mainly to the aorta and allowing most of the blood returning from the body to flow directly into the lungs. After this operation, all the blood returning from the upper body is sent to the lungs, so blood with more oxygen is pumped to the aorta to supply organs and tissues throughout the body.
Step 3: The Fontan procedure. This procedure is done between 18 months and 3 years of age. It allows the rest of the blood coming back from the body to go to the lungs. After this procedure, there's no mixing of oxygen-rich and oxygen-poor blood in the heart, and your child's skin will no longer look blue.

Another surgical option is a heart transplant, especially when the defects are complex. Babies with hypoplastic left heart syndrome can be considered for a transplant. While awaiting a heart transplant, your baby may require medications until a donor heart becomes available.

Courtesy of the Mayo Clinic. http://www.mayoclinic.com/health/hypoplastic-left-heart-syndrome/DS00744/DSECTION=treatments-and-drugs