Caden's Surgery Tomorrow

Hi All,

  We met with Cadens surgeon today.  It was scary and intense.  He made sure we knew this was major heart surgery and that there are several things they will be doing that are all high risk.  I will try my best to explain everything well. 

The Plan:  Dr. Kanter explained they will be doing the Ross procedure and fix the coarctation (narrowing) as we expected.  He also said they will do a Konno procedure as well, because Cadens aortic valve is too narrow to fit his pulmonary valve they will put in its place.  To make it fit they will make an incision in the heart muscle so the valve fits well.   They did another echo this morning to ensure his left ventricle had the proper function to pump blood through his aorta, and indeed it is strong.  They are going to put in a pulmonary valve tomorrow as well.  They will use a piece of his paracardium sac (it surrounds the heart) to make a valve.  This is good because he will not need anitrejection meds.  Dr. Kanter said there is a small, very small, chance they can fix the coarctation and dilate the valve to open it up.  This would buy time to do a valve replacement when he is a few months older.

  We will get to hold him tomorrow morning before he goes to surgery.  They will take him back at about 7am to get all the lines in him and put on a ventilator.  They will probably make the first incision around 830 or 9am.  Once they open him up they will get him started on bypass, confirm the plan, and stop his heart.  From there we are told to expect surgery to be at least another 6hrs.  He will likely return to the CICU (CardiacICU) with his chest still open.  They will sew a plastic sheet, looks like plastic food wrap, to his chest to keep everything clean.  They will leave his chest open because the trauma of the surgery will cause severe swelling that will put pressure on his heart.  If they leave it open they will come back in 2-3 days to close his chest, once the swelling has gone down.

The scary:  There is a 90% chance of survival...good, but not the odds you like when its life and death.  Dr. Kanter has done this surgery over 100 times, but only 4 time on newborns.  He tells us that Caden has a very special heart that requires a very major and delicate surgery.  They will need to avoid kinking the vessels that supply the heart muscles with blood, it they get kinked he will suffer a massive heart attack.  They also need to take care to avoid the tissue that send the electric pulse that causes the heart to pump.  If they hit that Caden will need a pacemaker.

  He will have several lines in him supplying him with sedatives and pain killers. He will have 2 chest tubes, an external pacemaker, a ventilator, and a catheter.  It is going to be completely overwhelming to see him in that condition.  He will not feel the pain and will never remember the any of his hospital visit.  We will. We have been encouraged to take pictures of him so he can show off his battle scar and have pictures to share the story.  Also, so he will understand why we get so concerned when he does what boys do.

We are feeling peace tonight, and i hope and pray we will continue tomorrow.  We will get updates every 1.5-2 hrs and we will be sure to pass them along.  We are glad the surgery is tomorrow as we feel we are living two lives, one at the hospital with out son, and one at home with our daughter.  We feel and appreciate your prayers.  We are numb to our emotions right now, but are often reduced to tears by the story of Gods ministry through our 5 day old son.  We pray we will be an adequate voice to share Cadens story of God's goodness.  Caden is a fighter, his heart is strong.  We had no idea the meaning of his name until we googled it last night...Caden - Spirit of Battle/Fighter.  He will live up to his name.  We love you all!

Adam