Grammy had a great idea to email cousin David for some help understanding a bit more about pressures and Fenestration and stenting. His descriptions are incredibly helpful, so I wanted to share it with everyone else. David has extensive hospital experience as a respiratory therapist and is studying to be a physicians assistant. There have been many days when we wished he was standing by our sides deciphering all the technical lingo.
Normally we have the MASS pike running into Rt 93. A nice big road that can carry lot of volume and its 4 lanes. Not a lot of back up (IDEALLY).
Just like we have our superior Vena Cave(SVC) and our inferior vena cava (IVC) running into our right atrium of the heart. NOt a lot of pressure, big wide roads.
Mass pike goes down to 93 then smaller down to 128 to Rockport with all its little roads.....to stockholm ave. just like from the heart to the lungs, normally.
Usually from the Right side of the heart, it can handle the volume of blood, not a lot of back up, and it pumps it forward using pressure into the smaller, but strong pulmonary arteries and into the lungs with small vessles where there more pressure, but since the heart is pumping it forward, it can't go back....
Well with Riley, the mass pike is like his(SVC/IVC) and bypasses the heart nad hooks up to 128 directly (pulmonary arteries), going from 4 lanes down to 2. This traffic jam/bottle neck leads to back up of blood, Without going to the heart to pump it forward directly into the lungs, backs up into the liver and sounds as though it leads to some unkown process in the liver which causes protein to leach out into the intestines. (osmotic pressure blahh blahh blahh)....
What they need to do, and sounds like they are going to is image the area (MRI)and see if there is some sort of anatomical "road block". and/or go to the cath lab and measure the pressures and see how high they are.
They can then either stent open the anatomical "bottle neck" at the mass pike/128 junction or they may have to build a bypass road (Fenestration) running off to the right heart. This allows all the backed up "traffic/pressure" to be releived and to go through the heart and pumped out, some into the lungs, but some into the body (due to his heart defect) without being oxygenated.
Long story short, its a waiting game for them to diagnose exactly what is going on. They may need to just stent some sort of narrowing...which they can do in the cath lab, or they may need to build the "bypass road" (Fenestration) with an operation.
4 comments:
oh that david!
that was a good description! Now i understand better. Much love to you all and hope for the best
Marisa(cousin dave's wife :)
I hope you can avoid another "big dig." My thoughts are with you.
I know this stuff is totally serious but that explanation gave me a smile. I have so many visuals of Wren's heart in my head, I am sometimes floored trying to imagine another defect.
I too hope that the road works required are minimal and that the diagnosis comes quickly so Riley can feel his best.
Grampy here on pins and needles. Trying to keep up to date. Love you little guy. We want you to get better!
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