Thursday, June 4, 2009

What will take place during Cain's surgery?

Many of you have asked "What exactly will take place during this surgery?" I hate that my answer always has to be...."Brad explains it much better than I do." The following is Brad's explanation. After reading his explanation...I'm sure you will see why I don't attempt to explain each surgery. Thank goodness for his medical background. I don't know what I would do without him helping me out with this!!

Tomorrow Cain is going to have his 2nd open heart surgery and it is called the Bi-directional Glenn Operation. The surgery will included removing the Gortex BT shunt that was placed during his first operation and replacing it with a natural shunt that will grow as he does.

The bidirectional shunt is performed by connecting the superior vena cava (SVC) to the pulmonary artery. Now, venous blood from the head and upper limbs will pass directly to the lungs, bypassing the heart. This will reduce the amount of un-oxygenated (blue) blood that is currently being mixed with oxygenated (red) blood. Dr. Bichell has indicated that his oxygen saturation's should increase to the 85 -90% range and this will also improve his overall skin color where he will look pinker and not as blue. The surgery will reduce the work load of the left ventricle which has been pumping blood to both the body and the lungs since the completion of his first surgery. Cain will continue to have blue and red blood mixed as venous blood from the lower half of the body will continue to enter the heart through the right atria (this will be directly routed to the pulmonary artery during Cain’s third surgery).

There is some concern about the narrowing of the left pulmonary artery. Dr. Bichell intends to address this by placing the SVC in the area that has narrowed. Using biological material or a synthetic patch, they will be able to widen the artery. They will then remove the band that was placed around the right pulmonary artery during the first surgery. This should equalize the pressure between the two pulmonary arteries and will also allow them to grow at the same rate.

Although, not as risky or complicated as Cain’s first surgery, this is a major procedure and will require the use of the cardiopulmonary bypass machine again. It is expected that the entire process will take 4 -5 hours.

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