One Year Surgery Free!!!

Yay Andy!!! He is our little fighter and he has made it to his first birthday without needing any surgery. This is impressive because Dr. Pulver said he thought Andy would need intervention by now. When he first met Andy he said he had a 'gnarly' valve and we were going in every six weeks. Now we are scheudled six months out. Andy is fighting this thing and we are grateful God has given him time to grow. Keep doing it buddy!

The update...

I'll make this as short and sweet as possible. It's good news and bad news. Bad news first, his valve has not shown significant narrowing however his valve is leaking a lot more. This forces us to re look at our plans for intervention. We had originally planned on him having a balloon catheter which is far less invasive than open heart surgery. This most likely won't be an option now. He will probably need to go right to surgery and his Doctor finally put a name to what operation he will probably need; Ross Konno Procedure. Yuck. Very complicated heart surgery. But I DID say there was good news; he doesn't have to go back in for 6 months! He has never been allowed this amount of time in between visits. His doctor said the leaking valve will not necessarily mean he needs surgery sooner. We will watch the gradients, and monitor the size of his left ventricle and take it from there. Please keep him in your prayers.

What is the Ross Konno Operation?

It's complicated, (as well as a complex surgery) but in layman's terms it means that they will take out his diseased aortic valve and replace with his own pulmonary valve. He will then get a pig valve in the place of the pulmonary valve. The reason for trading valves is because the pulmonary valve get less 'traffic' and is better able to handle the pig valve in it's place rather than the high traffic aortic valve.

If you think you can handle the medical explanation here it is:
The Ross-Konno procedure is an excellent technique for the treatment of complex multilevel left ventricular outflow tract obstruction with severe annular hypoplasia and a dysplastic aortic valve. The operation can be performed earlier in life, thus avoiding repeated surgical reinterventions, which may provide only short-term palliation and potentially exacerbate ventricular function. The Ross-Konno procedure increases our therapeutic choices for neonates or infants with critical aortic stenosis, who show unacceptable results following open valvotomy or balloon valvotomy. The pulmonary autograft demonstrates durability without the likelihood of developing aortic stenosis or progressive dilatation and a low incidence of developing aortic insufficiency. Despite the technically demanding nature of the operation, the Ross-Konno procedure is the method of choice for the multilevel type of left ventricle outflow tract obstruction, especially in newborns and infants.

What is Aortic Stenosis?

Aortic valve stenosis is a narrowing of the aortic valve. The aortic valve opens to allow blood to flow from the left ventricle of the heart to the aorta, and then to the body. Because the opening is narrowed, the left ventricle has to pump extra hard to propel blood through the valve. This causes the left ventricle to become enlarged. The valve may also have two leaflets, instead of three, or may have an abnormal funnel shape. The narrowed valve may not be a problem during infancy, but becomes one as the child grows and the heart cannot keep up with the body’s demand for blood. “Congenital” aortic valve stenosis means the condition is present at birth.

Taken from: http://www.hmc.psu.edu/healthinfo/c/conaorticvalve.htm

Saying Goodbye to Dr. Pulver

We are grateful that Dr. Pulver has kept such a close eye on our little guy. He is moving on now to live in North Carolina and we wish him all the best. We love our cardiologists and are looking forward to getting to know our new one.