We had an eventful last two weeks. Since learning about the pulmonary stenosis that threatens the free blood flow to the lungs from Ry' heart and her decreased right ventricle function, her incision site got a localized infection. We checked into the hospital on Sunday 9/09 and were released after monitoring and IV antibiotics Monday afternoon. She’s such a trooper. Her site looks much better now and her zipper is looking beautiful!
We saw her cardiologist on Wednesday 9/12, and she said we can come back in one month and they will see if there has been any changes in her heart (Echo and EKG). They want her to get to a couple of month from birth and surgery to do the next procedure as they want the area nicely healed. We don’t want to see her heart condition declining so the next procedure will be done as proactively as possible.
So what is ventricle stenosis and what can be done?
For Ry she will have a balloon procedure at some point in the next month or
two.
Pulmonary valve stenosis
Source:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002086/
Valvular
pulmonary stenosis; Heart valve pulmonary stenosis; Pulmonary stenosis;
Stenosis - pulmonary valve; Balloon valvuloplasty - pulmonary
Last reviewed:
June 7, 2012.
Pulmonary valve
stenosis is a heart valve disorder that involves the pulmonary valve.
This valve
separates the right ventricle (one of the chambers in the heart) and the
pulmonary artery. The pulmonary artery carries oxygen-poor blood to the lungs.
Stenosis, or
narrowing, occurs when the valve cannot open wide enough. As a result, less blood
flows to the lungs.
Causes, incidence, and risk factors
Narrowing of
the pulmonary valve is usually present at birth (congenital). It is caused by a
problem that occurs when the unborn baby (fetus) is developing. The cause is
unknown, but genetics may play a role.
Narrowing that
occurs in the valve itself is called pulmonary valve stenosis. There may also
be narrowing just before or just after the valve.
The defect may
occur alone or with other heart defects that are present at birth (congenital).
The condition can be mild or severe.
Pulmonary valve
stenosis is a rare disorder.
In some cases,
pulmonary valve stenosis runs in families.
Symptoms
Many cases of
pulmonary valve stenosis are mild and do not cause symptoms. These infants are
usually found to have a murmur on a routine heart examination.
When the valve
narrowing (stenosis) is moderate to severe, the symptoms include:
- Abdominal distention
- Bluish color to the skin (cyanosis) in some
patients
- Chest pain
- Fainting
- Fatigue
- Poor
weight gain or failure to thrive in infants with severe
blockage
- Shortness of breath
- Sudden
death
Signs and tests
The health care
provider may hear a heart murmur when listening to your heart using a
stethoscope. Murmurs are blowing, whooshing, or rasping sounds heard during a
heartbeat.
Tests used to
diagnose pulmonary stenosis may include:
- Cardiac catheterization
- Chest
x-ray
- ECG
- Echocardiogram
- MRI of the heart
The health care
provider will grade the severity of the valve stenosis to plan treatment.
Treatment
Sometimes,
treatment may not be needed if the disorder is mild.
When there are
also other heart defects, medications may be used to:- Help blood
flow through the heart (prostaglandins)
- Help the
heart beat stronger
- Prevent
clots (blood thinners)
- Remove
excess fluid (water pills)
- Treat
abnormal heartbeats and rhythms
Percutaneous balloon pulmonary dilation (valvuloplasty) may be performed when no other heart defects are present.
- This
procedure is done through an artery in the groin.
- The doctor
sends a flexible tube (catheter) with a balloon attached to the end up to
the heart. Special x-rays are used to help guide the catheter.
- The
balloon stretches the opening of the valve.
Expectations (prognosis)
Patients with
mild disease rarely get worse. However, those with moderate to severe disease
will get worse. The outcome is good with successful surgery or balloon
dilation. Other congenital heart defects may be a factor in the outlook.
Most often, the
new valves can last for decades. Others wear out and will need to be replaced.
Complications- Abnormal
heartbeats (arrhythmias)
- Death
- Heart failure and enlargement of the right
side of the heart
- Leaking of blood back into the right ventricle (pulmonary regurgitation) after repair
