Riley needs an MRI, keeping fingers crossed for surgery as scheduled

Yesterday the nurse practitioner called us to say that Riley needs a battery of tests that have been overlooked. The surgeon is concerned about the venal return from his liver. Normally, veins from the liver drain into the inferior vena cava. However, with Riley's anatomy, organs and veins often aren't where they're supposed to be. Kids with Riley's condition often have hepatic veins that connect separately to the heart. If these aren't modified during the Fontan, oxygen poor blood will still end up in the heart and the kids will still be blue. To prevent this, any hepatic veins will be removed from the atrium (usually as a patch) and reattached to the pulmonary artery with the IVC.

Riley's surgeon, Dr. Karl, asked about the hepatic veins when he saw Riley's case on Tuesday, and unfortunately they had been overlooked. The heart cath would have been the perfect time to investigate them, but alas it didn't happen. So we had an echocardiogram this morning. The echo showed definitive evidence that Riley does have hepatic veins that bypass the IVC, but it didn't give enough specific information for Dr. Karl to operate with. So we're now scheduled for an MRI at 12:30. Hopefully the MRI will give Dr. Karl specific data about which veins are going where to help him decide what to reattach during surgery.

So what happens if the MRI doesn't give us conclusive information? This is the bad news. Dr. Karl will order another cath and reschedule surgery. That means we'll have to go through everything we went through last Thursday and surgery would be rescheduled for another time. And presumably the cath wouldn't happen today, which means we go home, come back again for a cath and then surgery at some later date. Let's keep our fingers crossed that Dr. Karl gets all of the information he wants from the MRI.

Riley will be sedated for the MRI, he'll receive versed in about an hour and then something stronger to put him out. After the MRI he'll be recovering in his room on 6 North. He'll also need a chest x-ray and an EKG at some point this afternoon. Fortunately it looks like he won't need any additional blood tests, which we had hoped. The nurse practitioner is looking into that. If they do need more blood, hopefully they can take it while he's out before or after the MRI.

Suzanne, Grampy (Jack) and Grandma (Gail) are all here, Grammy (Peggy) arrives this evening. Suzanne and I will stay in the hospital overnight with Riley. We'll keep everyone posted.