This was a good week for us. Kireta and I were a little apprehensive going into our cardiologist appointment on the ninth. If you've followed our previous post, you'll know that at Logan's last appointment they found some blood flow from Logan's left ventricle (bottom right chamber of the heart) to his right atrium (upper left chamber). Also, his pulmonary stenosis was a bit higher than we would have liked, at 46%.
However, this last visit proved to be very positive! Our cardiologist, Dr. Villavincencio, came into the room to supervise the echo-cardiogram. She was very pleased by the results, as his pulmonary stenosis was down to "ideal" levels at 33%. She explained that a zero level of stenosis would mean total leakage up and down his pulmonary artery, thus getting unwanted backflow into the right ventricle. Conversely, too much stenosis would mean his heart would have to pump to hard to get blood to his lungs. So, again, we're very thankful that his stenosis levels are "ideal."
Logan seems to be happy with the results as well:) Also, Dr. Villavincencio had to look quite hard to even find the blood flow from the left ventricle to the right atrium. She described this leak as "trivial," and that if it remains this size, it will only be something to monitor, and not correct. I asked Dr. Carrie if it would need corrected, would they be able to do so in the cath lab (correction through the femoral artery in the leg), and she replied that at this time, surgical correction would be necessary, but in five years, who knows?
When asked if this blood flow was, in essence, a new hole, or something that was overlooked, the answer is not so clear. Because Logan's VSD patch was very high up between the ventricles, it also happened to be very close to the aorta valve. This is a no-man's land for surgeons, because the potential risk for damaging the aorta is very critical. So Logan's VSD patch was sewn in near perfect, however, a little leakage still occurs because of a small area not sewn up adjacent to the aorta.
So here goes my thoery (best case scenario by the way): The left ventricle is very high pressure. A small hole in the VSD patch would mean that high velocity blood (from the left ventricle) would "spurt" through the VSD patch. Because of it's location, it's possible that the blood spurt would be directed at one of the leaflets of the tricupsid valve (a one way valve from the right atrium to the right ventricle) and thus jettison into the left atrium, explaining the blood leakage. If this theory is correct, then the leak should also be temporary, as the heart will grow around the VSD patch and seal off completely in time. Of course, only time will tell, but we remain optimistic.
Thank you again for your continued support and prayers. Logan is a true testament that prayers work. For those of you in the Denver area, remember Logan's walk for Down syndrome is on Sunday, September 27th. We're looking forward to a great walk, and will update the blog following the walk. That's all for now!