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| When we went to the Cardiologist on November 8th they said that Daniel's stenosis was worse and that there were concerns because his heart was so "complicated." A Cardiac Catheterization was scheduled for January 8. This extraordinary tool is used to get exact measurements of the interior of his heart and judge the right timing for surgery. It requires and overnight stay in the hospital. a better picture of his heart was needed so that we could proceed with our plan to wait as long as possible before another surgery. We needed his little heart to grow as much as possible so that they have the best shot possible at repairing all the "complications." |
| 16 MONTHS MORE SURGERY? |
| Gradient Pressure difference...the term "gradient" is used to specify the difference in blood pressure before and after a blockage or stenosis. The gradient is a pressure difference (calculated by subtracting the higher pressure before a blockage from the lower pressure beyound the blockage). The severity of a blockage and the impact on circulation hemodynamics can be estimated by the magnitude of the gradient. This is particularly useful in estimating the severity of obstructive heart valve conditions. |
| Severity Mild Moderate Severe Critical |
| Mean gradient (mm Hg) <25 25-50 >50 >80 |
| Aortic valve area (cm2) >1.5 1-1.5 <1 <0.7 |
| disconcerting for a child this age, because the understand just enough to know that something is not right, but not enough to accept it and go to sleep. The Cath showed some concerns and some assuring news. The Coarctation repair looked beautiful! What was left of Daniel's VSD was closing up nicely. Unfortunately the stenosis was pretty bad. The effects of stenosis are measured with what they call a "peak to peak pressure gradient." Please see chart (provided from eMedicine)and defintion (provided by Cardiology Associates.) |
| 16 MONTHS AND MORE SURGERY? |
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Daniel's actual heart cath had no complications, but want to warn parents about something the doctors called a paradoxical reaction to the drug Chloral Hydrate. The child is given this or another sedative before the catheter. Daniel fought it very very hard. He was flailing around jerking and screaming. It was AWFUL. Please be prepared, a strong sedative is particularly |
| Daniel LOVES his barking pal! |