 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
This is the Clinical Zone Medical Photo Page for Samantha'a fan club.
I hope this helps you understand what exactly Samantha has been through. |
|
|
 |
|
|
To Start, This is the comparison between the Normal Heart and the Heart Defects that Samantha had, which include "Transposition of the Great Arteries" (Her Aorta & Pulminary Arteries were in the switched positions), Two VSD's, Ventricular Septal Defects (Holes in the heart) between the right and Left Ventricles (shown in brown), and some excess tissue connected to her Mitral Valve (shown in light grey). These defects made it neccesary for a "Blalock-Taussig" shunt (drawn in) to allow better blood flow for her first 6 months. Over the 6 months, her VSD's closed up more, and surgery was needed to repair the blood flow. |
|
|
|
|
|
|
 |
|
|
In October,2002, Samantha (6 mos. old) had a "Bidirectional Glenn" done. This made her heart into a single ventricle heart, pumping only with her left ventricle: so the Aorta (lettered "A") was tied off. At this point her VSD's ("B") were closed because as her heart works to pump that muscle builds up, closing the VSD's. In surgery, an attempt was made to open that up, but they grew shut again over the following months, and it was determined by Childrens' and MGH that it was best left alone, as it may do more damage than good to try to put in a stent. |
|
|
|
|
|
The Mitral Valve ("C") still had excess tissue on it, and it was too risky to mess with it, so the surgeon at Childrens' left it alone. If this tissue could have been removed safely, we could have done an artery switch, and things would have been better functionally for her heart, but that was not the case.
With the Bidirectional Glenn, the blood flow was redirected ("D") through the veins to the upper part of the body. The lower half is fine and gets blood flow, but at age 2-4, Samantha will need a "Fontane" operation, which will increase the blood flow to her lower body. |
|
|
|
|
|
|
|
|
Since her bi-directional Glenn surgery, she has had some eating aversion and vomiting immediatly following the Glenn. These led to Samantha having a Nissan Fundoplication (Click Here for more Info) and receiving a G~Tube Button (see below) in December 2002 to aid in
making sure she gets the calories and hydration that she needs. |
|
|
|
The BARD G-Tube Button |
|
|
The MicKey G-Tube Button |
|
|
|
|
|
|
 |
|
|
 |
|
|
|
|
The hose from Samantha's pump mentioned above connects to Samantha's stomach through a "GTube Button", which is basically the port to her stomach directly through her belly, above her bellybutton.
There are 2 kinds of buttons she has had: a MicKey, which is held in by a balloon filled with water...and was prone to bursting causing the button to come out entirely; and the BARD button, which has no balloon, but rather a rubber flat edge that goes against her stomach wall to hold it in. She had this for 4 months until we went back to the Mic Key in Oct 2003, because the Bard had issues wearing down. The Mic-Keyis still in today, though we change it now & then.! |
|
|
|
|
|
|
|
|
|
 |
|
|
 |
|
|
|
|
|
|
|
|
|
|
 |
|
|
This (right) is the setup we have for Samantha at night, since December (Merry Christmas!) 2002 until we get closer to her Fontan operation. It involves putting her formula in a plastic bag with an ice pack. The bag has a hose which runs through a pump regulating the speed at which she gets the formula overnight. We are currently at 60 ml/hr (this converts to 2 ounces/hour) for 12 hours. Dec 2004, she was weened down to 6 hours a night.
Then enetually to no tube feeding at May 2005!
She continued to keep the gtube button for 2 years,
for medication strictly.
On March 30th2007 the button water balloon broke, the button came out, and Samantha decided it was time to leave it out! Yahoo! Way to Go Samantha! |
|
|
|
|
|
On January 6th, 2005 at Children's Hospital, Dr Pedro DelNido did Samantha's Fontan surgery with multiple repairs.
Here's what they did...
The Fontan itself:
constructing a wall inside the right ventricle
to reroute the blue blood to the lungs,
allowing better blood oxygenation.
A Fenestration (a small hole) was put in the Fontan wall to act as a pressure valve, to relieve some of the pressure.
..................and then the repairs............................
-The left ventricle was decompressed after putting in a stent between the 2 ventricles. This allows the left ventricle to help the right ventricle pump.
-The Mitral valve was repaired - one of the valve's flaps was actring as a windsock, catching blood in it, so that was sewn up.
-There was an aneurysm (a pouch of extra tissue in which blood was pumping ) connected to the right ventricle.This was mended, but the patch covering the entrance to the aneurysm could only be mended from the inside. |
|
|
|
|
|
 |
|
|
|
|
|
|
|
|
On Dec 17th 2004, (2 yrs old) Samantha had a cardiac cathe, and they put Platinum coils around her Collateral vessels, to lessen the bleeding for her upcoming Fontan surgery on Jan 6, 2005. These vessels go from the heart to lungs, and blocking them will prevent too much blood flowing to her lungs. Here are Xrays showing the Coils. |
|
|
|
|
|
|
|
|
|
CLICK HERE to see photos of Samantha while at Children's Hospital (2005). |
|
|
|
Sami showed her bravery enduring 6 hours in the Cathe Lab at Childrens'
on 1/9/07 (4 years old), only to wake up asking, "where's my toy?"!
She had this cathe as a follow up, but Dr Lang (who said there was much drama in the cathe lab) closed her fenestration on the Fontan wall, which may help her SATs go up to around 90, rather than 85.A little scarey thhhing was when they first put the device in place to do this, it didn't sit correctly, so they had to retract the device and reinsert it successfully. The 2 VSD's have stents that looked fine, so they didn't touch them. There were a few collateral vessels that developed and were not needed, so they closed some off (as they did above left in earlier surgery) with some more titanium. These will be watched, and if her SATs go down again, they may close more collateral vessels at a later point. |
|
|
|
Click Here to return to Samantha's Main Page |
|
|
|