Open Heart Surgery #2...maybe

Lydia had an appointment with the cardiologist on Monday and we received some disturbing news.

Back track to our visit in September.  Lydia's EKG was great. Lydia's echo was pretty good.  We knew there was some left ventricular obstruction stenosis.  At the time we were told it was probably due to a small aortic valve which could be ballooned open in the cath lab.  This was not entirely unexpected and not too hard to swallow.

Dr. Shah described Lydia's blood flow like a garden hose you put your thumb on to get a more pressurized spray.  This means the heart muscle is working harder and getting thicker, like any muscle that is worked out.  At the time, this overcompensation of the heart muscle was expected and manageable.

Fast forward to Monday's visit.  Lydia's EKG was great.  Lydia's echo was okay.  It is much clearer now that the left ventricular obstruction stenosis is just under the valve in the left ventricle itself.  This cannot be fixed in a cath lab.  This requires another surgery to open the area.  Opening this pathway will allow the pressure to subside and the muscle to atrophy to normal size.

Dr. Shaw described it this time in numbers.  You and I have blood flowing through at a rate of 100 ml per second.  Lydia has blood flowing through at 400 ml per second.  If this isn't lessened, the heart muscle will continue to thicken and eventually cause blood to back up in her lungs and cause respiratory problems.  

Dr. Shah will spend this week consulting with the other cardiologists that know and follow Lydia.  He will also consult her heart surgeon.  There are three possible things that could happen and I just have a feeling it's going to be option 3 by the way he presented this.

Option 1: Wait, keep watching, the LV grows and takes care of the problem itself.
Option 2: Check for valve stenosis and balloon it, possibly lessening enough of the pressure to not warrant surgery.
Option 3: Open heart surgery to open the area, lessening the pressure and relaxing the muscle.

It's not an urgent matter, but I don't think it's a wait until she's 3 or 5 or 10 matter either.  It's coming.  I'm strangely calm about it all because it isn't real yet.  The word isn't final.  The surgery isn't scheduled.  Lydia isn't in the hospital.  Yet, I'm trying the live with option 3.  In the back of my mind I'm trying to prepare for another open heart surgery.  Another day long wait.  Another set of IVs and meds and tubes and vents.  There are some really good people in the PICU, I just wished we'd never have to see them again.