Remember biology class? Not much? I remember there was one section on studying the heart but it's content escapes me now. Now, we've had a recent crash course - and a renewed appreciation for what we do not know! There is a vast expanse between what we begin to grasp and the science that prevails! So, from our experiences with Teo and much help from the encyclopedia of Google, here is a summary of what ails Teo's heart:
AVSD congenital heart disease occurs during the first eight weeks of a baby's development in the womb. It is a fairly common defect, accounting for about 5% of all congenital heart defects and the most common heart defect to occur in children with Down syndrome, accounting for about half of the total. From personal experience, doctors have also told us that this is a typical heart defect and that Teo remains stable – as in, they've seen this before and nothing of his heart condition has changed since it was first detected at the 18-week ultrasound. And although we remain anxious about such a serious surgery, we are astounded at the science known about the heart and the successful surgeries performed routinely and take some comfort.
A heart "septum" is a wall between the heart's left and right sides. It separates the two atria (upper chambers) or the two ventricles (lower chambers). The septum between the two heart atria is a thin membrane, while the one between the two heart ventricles is thick and muscular. AVSD is a result of the membranous and muscular atrioventricular septum developing abnormally. In its complete form, there are holes in both the septum between the top chambers (atria) and the septum between the bottom chambers (ventricles), and one common valve between the two atria and the two ventricles instead of separate mitral and tricuspid valves.
Depending on the type of AVSD, the already oxygenated blood may be re-circulated to the lungs, which is inefficient. The left ventricle also tends to have to work harder, which increases pressure to the lungs. This can cause the lungs to overfill with blood, potentially causing it to leak into the air around the lungs. This pulmonary edema can lead to congestive heart failure. As we understood for Teo, one critical point at which we needed to watch for heart failure was between 4-6 weeks of his life. We consider ourselves extremely fortunate then, and have been since, that we have not needed to rely on medications or oxygen due to congestive heart failure. Teo has never been required to be on medications to date. Blessed.
An AVSD will never close on its own and will always require corrective surgery for treatment. For infants with a complete atrioventricular septal defect, this usually occurs at 3-6 months. Surgical repair involves closure of the holes in the atrial and ventricular septa with a patch or patches, and reconstruction of the common atrioventricular valve. Of course, there are several possible complications that can occur and, right now, we are not focused on those and so, I do not share them here – the deciding factor currently is choosing life over death for little Teo and we proceed toward surgery with great hopes for his life. He is just over 5 months old.
Today, we expect to learn more. More about Teo's heart, more about surgery, more about everything, I suppose. Our day starts at 7am and, I expect, will be full of tests for Teo, orientation, information and more.
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