Heart Catheterization

Well… James is having a heart catheterization tomorrow morning. The reason is because his last chest tube keeps draining fluid. 

The heart cath doctor will go in with cameras to measure his pressures and look at his heart function to see what is causing the drainage. 

The cardiologists and surgeon believe the pressure might be high in the pulmonary arteries (PA), which would cause the fluids to keep draining. During the cath they will initially measure the PA pressure and see if everything else looks good from the surgery (which is a good thing to make sure of). The cath doctor will examine if the pressure can be controlled through medicine and then they will coil off some collateral veins his heart has developed. He had several collateral veins developed in the past to relieve PA pressure and were coiled during previous heart caths in Dallas. 

The next step will be to open up the fenesration (the hole from his Fontan tube to his heart) to make it bigger and allow some more deoxygenated blood escape to the heart, which will relieve the pulmonary arterial pressure. Subsequently this will lower his blood oxygen level since part of the deoxygenated blood comes in to the heart and then pumped out to his body. 

All these steps might not happen tomorrow, but were all discussed as options to stop the drainage.

If his PA pressure gets lower over time, the blood might bypass the fenestration and it could close by itself. The fenestration can also be closed during another heart cath later down the road which will bring his blood oxygen levels back up.  Right now his oxygen levels are ranging from low to mid 90s’.

This is not what we were hoping for, but seems to be the best for James right now. 

Wish him good luck tomorrow morning.