Aspen Moench Post OP

Tuesday, September 28, 2010

Open Heart Surgery Details

Mommy, Daddy, Nana Tana & Papa Todd walked down the long hallway to the entrance to the OR with Dr. Clarke.  Once we hit the big doors, they opened and it was time to say our Goodbyes.  There was a huge yellow line on the parents pass this point.  We all gave little Aspen hugs & kisses.   
Karsten held her for a few minutes.  I know he claims he never cries, but his eyes were pretty red as we handed our baby to Dr. Clarke.  We both admitted that was the hardest thing we've had to do thusfar in our life.  I don't remember the last time I cried that hard.  The tears just kept coming...even writing about it after the fact brings tears to my eyes.  Although I know we had to go through with this surgery I felt like I was sending my baby to HELL.  I would be scared to death and I'm an adult! I don't remember being nearly this nervous, even when I went in for my scheduled C-Section!  When we handed her over, she kind of looked at the Doctor saying, "hmm, your not my mommy or daddy" but our brave angel never cried once! We watched as her doctor held her in his arms and walked down the hall to the OR where they would be performing her surgery.  It was like that Poltergeist hall...ya know where it goes on forever!  As we walked slowly back to the Same Day Surgery Waiting Room Nana Tana & I were a mess...tears streaming down our faces.  Then something amazing happened.  In walks her Cartiologist, Dr. Polchalski, who diagnosed her partial AVSD.  He randomly gets assigned to the OR but never really knows when...but today he was going to assist in Aspen's surgery.  That lifted a small load off my shoulders knowing he was in there with the surgeons watching over the surgery.  The Lord new I needed and extra dose of His Tender Mercies that day and this was definitely one of them.

She was went into the OR @ 7:38 am. It takes about 1.5 hrs from when they get in the OR before they make the incision to do all the prep work.  Our first update would be when they make the actual incision.  They called us in the waiting room at 9:02am to let us know they had made the incision and the heart repair was underway.  After that point, they gave us hourly updates as the surgery progressed.

About 11:30am, I received the final update that she was off the heart/lung machine and they were ready to close her up.  Her cartiologist came first and gave us a report that the surgery had gone "picture perfect," that she had done amazingly well and when they opened her up it was exactly what the doctors expected to see.

Her surgeon, Dr. Burke came next and took us into a consultation room to discuss the surgery.  In so many words he told us the surgery went very well, but its obvious as the liable party they have been trained to be VERY CAREFUL what they say for liability purposes.  We asked if this would be her only surgery and although you could tell he wanted to say "yes" his liability insurance didn't allow him to....he said the fix went very well but there was no guaranteeHe gave us the anatomical explanation, most of which I understood having been dealing with this for nearly a year now.

For those of you who actually understand this stuff (AARON), I'm going to put a disclaimer as I'm reporting what I remember hearing and if its not anatomically correct you are free to call me up to correct my ignorance.  

When the surgeon got in, the first thing they fixed was the valve that was a single valve needing to be split in two.  They called it a "cleft" and the surgeon said it was actually longer than they thought.  He put in 4 stitches to close the cleft and split the valve.
He said Aspen likely had a full AVSD early on including a small hole in the 2 bottom chambers (Ventricles), but this flap from the cleft had folded over the likely hole and created a "shunting affect" not allowing blood to pass through.  He said because it was covered, that hole closed on its own.
I had wondered about this because when we had done the 2nd ECHO a month before she was born (an ultrasound machine that measures many things about the heart including blood flow which reveals holes), Dr. Polchalski mentioned there was very, very faint blood in the 2 ventricles and although there didn't appear to be a hole there, they couldn't rule it out. It all made sense now.
Next, they repaired the hole in the between the 2 Atria with part of the sheath surrounding the heart.  All of us have a membrane surrounding the heart that must be partially removed to get to the heart with Open Heart Surgery.  The beauty of it is they were able to use the small section of sheath they removed to patch the hole, which means no foreign objects was required to close off the hole (sorry Aaron, Goretex patches are great, but this is still the better option in my opinion!) .
Dr. Burke also mentioned her ductus arteriosis had not completely closed when she was born and they clamped that off and corrected that as well (if you recall from when she was born that bypasses the Aorta while a fetus and closes once they are born and using their own heart vs mommies).

We got to see her about noon and she actually looked better than I thought she would.  She had lots of tubes and chords, but was pink and overall looked great having just barely come from Open Heart Surgery.  Thusfar she has surpassed all her expectations of recovery! Since she was doing well and I couldn't breastfeed that night I decided to go home and get a good nights sleep...sweet dreams now that my baby was doing so well! They removed the breathing tube around 6pm yesterday which they didn't expect to do till this morning.  She drank 4 oz of my breastmilk last night from a BOTTLE (yes, I repeat, from a bottle something she has NEVER done).  The Nurse said when they get hungry enough its amazing what they will do.  She is doing amazingly well accredited to the faith and prayers of so many wonderful people like you! Thx for your prayers for our sweet little angel!

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