I thought I would share with you a schematic of what Reiss’ Glenn heart looked like versus the classic repair she had on Wednesday, May 25. The drawing below was completed by Dr Mckenzie.
While the apex of most hearts points to the left side of the body, Reiss’ apex points to the right (dextrocardia). Additionally, Reiss’ heart sits in the center of her chest, as opposed to the left side in normal patients.
- SVC – For the Glenn procedure Reiss had at 10 months, the superior vena cava (SVC) was rerouted from its connection at the right atrium and placed directly on the right pulmonary artery. This was the only way Reiss’ heart supplied blood to her lungs. For the Classic repair, this was reversed, and the SVC was put back on the right atrium.
- VSDs – the picture on the left shows two ventricular septal defects (VSDs), or holes in the septum between the two ventricles. During her procedure last week, these two holes were patched.
- Pulmonary Conduit – Reiss’ pulmonary artery was completely closed at birth (pulmonary atresia). The Glenn bypass option, as mentioned above, is what helped carry blood from the upper portion of her body into the lungs, bypassing the heart. In the Classic repair, her native pulmonary artery was ligated and a pulmonary conduit with valve was added, connecting her right sided, left ventricle to the pulmonary arteries.
- Pulmonary Branch – during her repair last week, the surgeons noticed that the pulmonary branch arteries were narrow. They widened them with a balloon catheter to help increase the blood flow through those vessels. Later in the week, they noticed a portion of the left pulmonary artery (LPA) was narrowed even further. Before placing her pacemaker today, they also widened this LPA.
The Classic repair will allow more blood flow to the lungs, hopefully decreasing the likelihood of collaterals and hemoptysis. We have already noticed a difference. With pulse ox readings in the mid-90’s, Reiss no longer has a bluish tint to her lips and fingernails.