On the Inside

Before Zachary had his Hemi-Fontan surgery last June, he underwent a cardiac catheterization (heart cath.) A heart cath is a test in which soft, thin plastic catheters (tubes) are placed in the large blood vessels usually in the leg and threaded carefully to the heart. The catheters are used to take pressure measurements inside the heart and to inject contrast or dye so pictures of the heart can be taken.  In Zachy's case, the cath measured pressures in his lungs and helped doctors take a good look at the anatomy of his heart to determine if he was a candidate for surgery.  (If you watched the video in my last post, you will recall that the Hemi-Fontan is not successful in children with high pulmonary pressures; they often need a heart transplant.)

The doctors injected Zachary with contrast dye and took chest x-rays to get a good look at him in preparation for surgery.  Here's what they saw:

Can you see a little ribcage and the four wires holding his sternum back together?   The darkened area is Zachy's heart!  The large area near the bottom is his left ventricle, the only effective pumping chamber he has.  The thin dark line to the left is the catheter coming up from a vessel in his groin.  And if you're a medical type, you may notice that his heart is slightly enlarged.  This is typical for patients with heart disease because the heart has an increased workload and the muscle thickens to compensate.


The above film gives us a good view of Zachy's pulmonary arteries (the U shape above his atria.)  The doctors found a narrowing of his PA in this cath, and Dr. Bove was able to enlarge it with human PA tissue during his surgery!  Though I'm not certain, I believe the large darkened vessel with the catheter may be his inferior vena cava (IVC), bringing back de-oxygenated blood from the lower half of his body to his heart.  (If you know for sure, please leave a comment, all ye more experienced readers!)  The IVC will be re-directed to bypass his heart and flow directly to the lungs in Zachy's final stage surgery, the Fontan.

Little Zachy is just as handsome on the inside as he is on the outside, don't you think?

Comments

  1. Debi RohrFebruary 10, 2010 at 7:42 AM

    HI Michelle, I just came upon your blog. I am a parishioner at SEAS and remember you and Steve from Mission Ministry. I saw both your names on the prayer list and our family prayed for yours, I just didn't know what was happening. I understand now. You have a beautiful family! I will keep little Zachary and your family in our prayers....God Bless,
    Debi Rohr

    ReplyDelete

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