Care4Conway: In the Cath Lab

Monday, August 24, 2009

In the Cath Lab

Connie is now in the cath lab. As of 1pm Eastern they took him back and gave him the gas. He did not like the NP that was testing him. He never fusses for pacemaker checks and this one was quite long and he cried through the whole thing. We were also told that they would be getting all his blood and echo done after he was asleep but they wouldn't start the procedure without an INR level so he had to get a toe poke/squeeze anyway. He also didn't like the versed in the nose, but it did the trick of making him loopy. By 1pm he was quite hungry and tired and fussy with being messed with so even with the pre-med on board he was still quite agitated. We should get another update around 2:30 eastern time so I'll try to post then what is happening. Dr. Bradley and Dr. Ayagari(sp) are doing the cath and EP. We remember Dr. A from the last time we were here. He took care of Connie in the ICU for part of the time. He said he would be surprised if Dr. Bove didn't replace the conduit because the mitral valve is actually behind the conduit. It would be incredibly difficult to get in there to repair it without cutting out that conduit first. I asked Dr. Bradley about how many successful ablations have been done here on kids with Connie's anatomy, meaning, kids who have had a senning procedure. He said Connie would be the youngest (smallest) ever. Here's to making U of M history! Hail, Hail Michigan!!! Okay, Aunt Barb and I are starving so we are going to grab a bite before the next update. Since he couldn't eat, neither could we!

Oh, a note to the O'Leary kids: Your mom's phone charger is dead. She still has some battery, but has turned her phone off. You can call my cell # if you need her.

1 comment:

Yvonne Mallon said...: Anxiously awaiting to hear some news. Dr. Aiyagari was also Ella's cardiologist in the ICU. I really liked him. Connie is in very good hands.; August 24, 2009 at 12:44 PM

Conway's Heart Story

Conway's Heart Story

Conway David Beckemeier was born on March 3, 2007. His heart defects went undetected during pregnancy and he was diagnosed at two days of age with L-TGA, a large VSD, sub pulmonic stenosis and Ebstein’s Anomaly. Just before turning six months of age, he underwent open heart surgery to reroute the bloodflow in his heart. Called the "double switch", this procedure is the most technically challenging for pediatric cardio-thoracic surgeons to perform. The version of the double switch that Conway received on 8/28/07 was called the Rastelli-Senning with VSD closure and sub pulmonic resection. He suffered a grand mal seizure following the surgery that lasted over an hour and had several other post-op setbacks including surgical heart block, which required another operation on 9/18/07 to insert a pacemaker. Following surgery and such a long hospital stay, Conway developed an oral aversion (he would not eat) and he was 100% NG tube fed for eight months. He also lost muscle tone and required both physical and occupational therapies. In April 2008, he had a cardiac cath and attempted balloon angioplasty on his pulmonary arteries that did not work. Although his recovery was very long, he had a solid year or so of being a "normal" kid . Then in May of 2009, it was discovered that Conway was having rhythm disturbances, specifically atrial flutter. His pacemaker allowed it to go undetected for several weeks until he showed signs of heart failure and was admitted to the ICU for a week to be placed on IV heart meds and undergo cardioversion on 5/6/09. He went home and his heart function started recovering when he had another episode of flutter (6/16/09). This time, he was again hospitalized and put on IV milrinone, but he converted back to normal sinus rhythm by himself. At that time he was placed on the anti-arrhythmia drug, amiodarone. On 7/22/09 he had to be cardioverted again for yet another episode of flutter. The following week, he got worse instead of better. His cardiologist did a full work up and it was determined that his aortic, mitral and tricuspid valves were all leaking worse and were felt to be the cause of his heart failure. On 8/24/09 he had a cardiac cath and attempted ablation. The electrophysiologist was unable to induce a single arrhythmia. Then, just two days later, he went into atrial flutter on his own. He was placed back in the cath lab where he underwent mapping and a total of 17 burns were made to try to knock out his arrhythmias for good. The next day, 8/27/09, he had his second open heart surgery to repair his mitral valve called ring annuloplasty. He also had a partial Maze procedure done. His surgeries are performed at C.S. Mott Children’s Hospital at the University of Michigan (Ann Arbor). This time he was discharged just six days later! His Left Ventricular function improved drastically. In December 2010 we noticed he began getting more winded during physical activity. A January 2011 cath showed that he is outgrowing his RV-PA gortex conduit, but he was not symptomatic enough to warrant intervention. In April 2012 Conway’s fatigue increased and an echo at the end of May revealed that the ratio between the right and left sided pressures has gotten too high and it is time to replace the homograft that was placed when he was five months old. He had a cardiac cath on 5/25/12 which confirmed the echo findings. He had surgery on 8/8/12 to replace his pulmonary valve and RV-PA conduit, add an additional pacing wire to his left ventricle, and change his generator to a bi-ventricular model which is shown to preserve function and help the heart muscle pump more efficiently/effectively.