Thursday, September 10, 2009

Heart Drawings and Explanations


I thought I'd show you a diagram of a normal heart. If you really look at it, it describes very well the functions of a normal heart.

Besides my kid's drawings, which I love, I have come to depend upon a few drawings from our baby's Cardiologist. Since I am a very visual learner, the drawings mean more to me than hours of explanation. So, stay with me as I expain things to you.


Specifically, these simple drawings are not based on the structure of a normal heart, but our baby's heart. For our baby, the bottom chamber of the heart, his right ventricle, did not form at all. There is the tiniest hint that it wanted to start developing, but never did. Coming off that ventricle is the Pulmonary Valve. It should have a nice valve that opens and closes, allowing for one-way blood flow from the lower ventricle to the lungs. The muscle of the ventricle, in theory, should be taking that low-oxygenated blood that just finished circulating through the body, and pump it through that valve, up through the artery, and into the lungs so that it can get oxygenated.

From there, the blood that is now high in oxygen, comes back into the heart on the left side, goes down into the left ventricle, where it is then pumped to the body to oxygenate everything.

So with his right ventricle missing, and an essential valve not working, how will our baby get oxygen throughout his body? As you see in the next picture, there are two openings that are vital in keeping our baby alive. The first is an opening between the two top chambers (or atriums) of the heart. This allows the blue blood (low oxygenated blood) to mix with the red blood (high oxygenated blood). Normally this is so minimal, because of the low pressure/high pressure system, that it doesn't make much of a difference. However, because in our baby, the blue blood has no other place to go, because of the missing right ventricle, the blue blood gets pushed over to the left ventricle, and is then pumped back through the body. This means that although blood is getting pumped through the body, it is constantly getting blood without oxygen in it. Without treatment, the baby cannot live much longer than a few days.

The next opening is something called the Patent Ductus Arteriosus (PDA). This is an opening that is present at birth, but normally closes within the first day or two of a newborn's life. It is an opening between the pulmonary artery (the part in our baby that is a closed off valve that tried to connect to the right ventricle) and the aorta. A small amount of oxygenated blood from the lungs actually comes through that aorta, and because that PDA is still open, some of that oxygenated blood is able to get into the left atrium, thus mixing with the low oxygenated blood, and getting pumped through the body.

It is imperative that the PDA stays open, so immediately after our baby is born, he will be put on medication called Prostaglandin (PGE), which will tell the body to keep it open. Because this won't stay open forever, within a day or two, the baby will have his first open-heart surgery. In this surgery, the Doctors will place a shunt to replace the PDA, thus keeping a way for the heart to receive some of the oxygenated blood from the lungs. Although the body will still get a lot of blue blood, he will get enough red blood to maintain some degree of health. This will be surgery number 1.

Surgeries number 2 and 3 will happen around the time he is 4-6 months old, and 2 years old. These procedures are called the Glenn and Fontan procedures. In steps, the arteries are re-routed to bypass the right atrium and ventricle of the heart. Instead, the blood will finish it's cycle through the body and go directly to the lungs to get oxygenated. From there, it will come back into the left atrium and ventricle to get pumped to the body.

As cautioned, the success of these surgeries depend on the size and strength of his pulmonary arteries, to see if they can withstand the extra burden, as well as how strong the left ventricle is, and whether operating on a one-pump system (instead of a two pump system) can be managed to give our baby as normal a life as possible. Without unforeseen complications or other areas of defects, the success rate is about 75%.

Hopefully this was a good update for you. I'm sure the heart functions at a much more complicated level than what I understand, but this was how it was explained to me.

19 comments:

Paula said...

Great explanation. Can't wait to meet this lttle guy in Novemeber (in the RS room or where-ever! I think I put gloves into my primary bag)

Maynards said...

Thanks for the info. Sounds like the doctors know exactly what will be going on, and you do too. We continue to pray that all goes well for everyone involved.

Andi said...

Your explaination was good, but I have a question. When he gets older will he be allowed to particiate in sports or run around like a "normal" kid. Does only having a 'one pump' system affect his activity later in life. Just curious?

runningfan said...

Thanks for the update! I'm glad to better understand what you're facing. You're doing a great job of staying positive!

Jeff and Lori said...

Great explanation! I'm also a visual learner and often drew out my own diagrams during my anatomy and physiology courses. You, your sweet baby, and your family continue to be in our prayers! (

p.s. just tried your "floating tacos" recipe...LOVED it and will continue to love it for probably a few days---makes a ton!)

The Girls' Mom said...

That was a great explaination, you did very well with something so complicated, you will continue to be in my prayers and thoughts, Love ya

shaina said...

Andi, to answer your question, he MOST LIKELY will not be able to exert himself as much as other kids will. He will have limitations, physically. Of course, we won't know until he grows more.

Chloe said...

This is a really clear explanation. I was actually able to follow it, and since I have zero knowledge of how the heart works that's pretty good.

You're doing great Shaina :)

Jen Sue Wild said...

Very good explanation!!
Did you draw those or did the cardiologist?
I still have the ones from William that our cadiologist drew..

Dan and Katie said...

Thanks for explaining it to us! I think I will read it a couple more times to make sure I get it. Modern Medicine is incredible.

Elise said...

Awesome explanation!!! Like Jen, I still have the drawings Matt's surgeon made of his digestive system and his surgery. Makes much more sense when you can see it, I think.

Adri said...

Crash course in cardiology! We continue to pray for health for your little one. And you, too.

Colleen said...

So fascinating! Our bodies are so miraculous and the things the doctors can do to fix the things that aren't working amazes me. Thank you for the information! Your sweet boy, as well as the rest of your family, is always in our prayers.

Andi said...

Thanks for answering my question Shania. I wish the best for you and your family. It is like my Mamma always says, "Only time will tell." :-)

LollyChops said...

I read it over twice and I understand better now. It's good to have an update from you Shaina. Just know that I am here for you no matter what. Even if it's just a few emails and warm words... I am here for you my friend.

The Brewers said...

You continue to be in our thoughts and prayers. xoxo

jkerbe1 said...

Thanks for the info shaina. I'm sure Joe will understand it better than me. But, you're explanation was very clear. I hope all is well. We will remember you in our prayers. Please let us know if you have a family fast. Your blog is awesome!!!! I need to start one now all the kids have gone to school. We miss you guys. It was fun seeing you in July. Talk soon.

Julee said...

This little one will definetly be in our prayers. :)

annafowler said...

Shaina,

I see now that you are dealing with MUCH more than just a cleft. My prayers are with you. I'm no heart expert, but if you have any cleft questions, email me okay? Good luck with everything. PS- I saw you mentioned crushed ice from sonic. Do they sell just crushed ice? I am so craving some RIGHT now.