Details for Graham's Surgery

We met with the pediatric heart surgeon at UNC last Friday. Graham will have a "full repair" of his congenital heart defect, Tetralogy of Fallot, on March 20 at UNC. I will attempt to convey to you all I know about the surgery but I am bound to get some terminology wrong. The surgeon will patch the VSD (the hole in between the lower two chambers) and widen the pulmonary artery with a patch. He will possibly cut away some of the muscle that is restricting the opening to the pulmonary artery. Here is a picture for those visual learners!

He will use part of Graham's pericardium, the sac containing the heart, for the patches. Apparently the pericardium is not essential and won't mind if it has a couple holes in it. To get to the heart they will have to break the breast bone. The bone will be put back together with stainless steel wire. (This is less visible through the skin than sutures would be. The wire will not set off metal detectors.)

Graham will be put on a heart/lung machine during the surgery to circulate blood and oxygen through his body while they stop his heart to perform the surgery. Once the surgery is complete, they unclamp something, blood flows back into the heart, and it starts pumping again. Simple... right? Donated blood will be used to prime the machine and will be circulated into Graham's body. Hopefully he will not need any additional blood transfusions.

The surgery should take 2-4 hours and Graham should be gone from us 4-6 hours. When he comes out of surgery he will be on a ventilator (breathing machine). He will have tubes draining blood and fluid from around his heart. He will have wires touching his heart for a temporary pace maker in case it is needed. He will also have a catheter, a big IV in his neck, a drain to his stomach through the nose and who knows what else. He will be kept on pain and sedation medicine as needed but will be somewhat alert. We will be in the PICU (pediatric intensive care unit) for a couple of days and then moved up to the pediatric cardiac recovery floor.

You may have seen this picture circulating the internet a while back of a baby boy who had the same surgery.

There are risks to the surgery of course. The two things that could cause big problems would be bad reaction to the anesthesia (which Graham had in November and should do fine with) and too much bleeding. Also, the area of the heart that controls the rhythm is near the hole that needs to be patched. If this is affected he could need a permanent pace maker. 

So that is way more than most of you wanted to know. Thank you Lord for modern medicine!