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Friday, August 14, 2009

Evan update

Evan went into surgery around 1:30, we expect a 4-5 hour wait til his surgeon, Dr. Devaney, brings him up to Pod A (PICU). We did learn that they'll be doing a little bit more than we first anticipated for this surgery.

Mitral Valve - this was the original reason we are having this surgery. His has a supravalval ring (basically, a ring of tissue above his mitral valve) that, along with his parachuted mitral valve is causing a back up (stenosis of mitral valve). Dr. Devaney is hoping to scrape this tissue, and slit the leaflets of the valve to open up the flow enough to hold Evan off of a mitral valve replacement for a number of years. Right now, his valve is a size 14, where the smallest replacement valve is a 16, so it would be very crowded, and the crowding would further hinder his 2nd problem...


Aortic Valve - this we were unaware of before talking to Dr. Devaney this morning. They've noticed that Evan has developed a subvalular membrane (ring of tissue) - right now, it's not having an effect, however there is a tendancy of problems developing quickly once it grows. Dr. Devaney is also planning to scrape at this ring during surgery today.



Evan's heart...
Both of these rings will impact his bloodflow throughout, and the 2nd ring (aortic) is likely a result of the impaired flow he's had for the last year. We know that this surgery isn't a cure all forever. The supravalval ring in the mitral has a low tendency of recurrence, however the subvalular membrane in the aortic does reoccur 10-20% of the time. Based on Evan's tendancy towards abnormal growth, this is likely. This 2nd ring (aortic) is further evidence to not replace the mitral valve today. By putting in a valve that's too big, it will further crowd the already small aortic valve opening.

Each procedure is quick, but the whole procedure takes 4-5 hours. We just received an update from the nurse (at 3:30) they were just getting through the scar tissue (from his last surgery) and putting him on the heart/lung machine (does all of the blood oxygenating during surgery). So far, everything was going great. Please continue to pray with us, and I'll keep you updated as we can!

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