A right heart catheterization was completed at 12 pm CST Monday, 16 Feb 2009 by Dr. John Warner http://www.utsouthwestern.edu/findfac/professional/0,,17742,00.html.
Good news! Decision rendered by Dr. Ring, surgeon http://www.utsouthwestern.edu/findfac/professional/0,,16089,00.html , is that open heart surgery is a go for Tuesday 17 Feb 2009.
3 primary indicators are all positive from the right heart catheterization, which is an invasive procedure to closely evaluate the pressures in the heart. A catheter was routed through Jennifer's femoral vein (in her right leg) into her right atrium, right ventrical, and pulmonary artery.
1). The first, pulmonary vascular resistance (PVR), has improved from 8.1 three months ago to 6.7. Measured in dynes, PVR is a term used to define the resistance to flow that must be overcome from the vasculature of the lungs.
2). Secondly, pulmonary artery pressure, a measurement of blood pressure in the pulmonary artery, has improved from 64 initially, to the 50s, and now resides in the 30s.
3). Third, the degree of "left-to-right" shunting. Jennifer has a hole in her heart, defined specifically as an atrial septal defect (ASD). The shunting can be defined by the volume of blood that flows through it for a period of time. In Jennifer's case, the volume has decreased from 4 liters to 2.5, representative of half the total that should be pumped from her heart to vascular system.
While the shunting is not ideal, it has both gone down and is an indicator of what could result during the recovery period. Meaning, significant progress quickly is possible after the surgery, given how much the shunt is being utilized.
Surgery is scheduled for 7 am. Jennifer will be wheeled down to the Operating Room (OR) at 6 am for preparations.
During the 3-4 hours, Jennifer's heart will be momentarily stopped. She will remain stable through the use of a heart-lung machine. During that time, a simultaneous repair will be made to close the hole in her heart and "baffle" her pulmonary vein.
One of Jennifer's pulmonary veins, typically architected to deliver oxygenated blood from the lungs to the left side of the heart, is currently "recycling" blood back into the right side of the heart. This creates a "loop within a loop."
The surgery will redesign this vein to deliver oxygenated blood, alongside the other pulmonary veins, to the left side of the heart.
Friends and family remain positive, highly optimistic, and confident. Despite the seriousness of the situation, we are all managing to share a few laughs.