The countdown... 3 days

Mandi, Claire and I headed to Nationwide Children’s Hospital today for the pre-admission procedures for Claire's next surgery. We talked with the Cardiac Anesthesiologist, Cardiac Nurse practitioner, and our friend Keyona, the Cardiac Nurse. I will share the specific information below about the specific steps of the Unilateral Bidirectional Glenn Procedure that Claire will have on Monday. The IV team also tried to get blood samples from our chubby Claire Bear. They started with the left hand.... no success, then the right foot... no success, then the right hand... didn't happen, then the last try.... the left foot. No luck. Obviously, our little girl was crying uncontrollably the entire time. I could stop thinking about this is the Claire Bear we are going to have for a few days post opt. Here we go. The Cardiac Nurse practitioner decided that the blood sample could wait until Monday morning.

Unilateral, Bidirectional Glenn
We will arrive to Children's Hospital bright and early at 6am. Like most visits to a doctor, the day will start with paperwork and checking insurance. Claire will get a physical examination with blood labs to prepare for the operation. We will be able to have two people back with her during the pre-op procedures. Around 7:30am, Claire will head to the OR for her surgery. The anesthesiologist will start with gas and then the team will get the central and arterial IVs in place. Then, the doctors will use cool packs and a cooling blanket to lower Claire’s temperature for the procedure. An incision down the midline will allow access to the heart through the breastbone where the heart will be placed on by pass and the heart rate slowed in preparation for the surgery.
The normal circulatory system has just one Superior Vena Cava (SVC). This blood vessel carries deoxygenated blood from the upper circulatory system back to the right atrium of the heart. Our special Claire has a little different anatomy. Instead of having one large SVC, she has two smaller SVCs.
The purpose of the Glenn procedure is to connect the SVC to the pulmonary artery. This will reroute Claire’s deoxygenated to the lungs, not the heart. The typical heart has two collection chambers (right atrium collects deoxygenated blood from the body and the left atrium collects oxygenated blood from the lungs) and two pumping chambers (the right ventricle pumps blood to the lungs, the left ventricle pumps oxygenated blood to the body). As you may recall, Claire basically has half of a heart. The Glenn procedure will alleviate some of the work her little heart has to do. Here is my best explanation of the steps of this procedure:
1. Place the blood flow on by pass to allow for the doctors to work on the heart.
2. Disconnect the Superior Vena Cava (SVC) from heart.
3. Stitch the hole in the heart where the SVC used to be.
4. Reinforce the lower side of the pulmonary artery where the SVC is to be attached.
5. Connect the SVC to the upper portion of the Pulmonary Artery.
6. Remove the shunt that was added during the last surgery.
7. Repeat the procedure for the other SVC.

Obviously, this procedure is a lot more complicated than the 7 steps I listed above. We know that Claire will have a pretty tough day on Monday 10-4-10. She will have a lot of tubes and wires post-op. Usually the parents are not encouraged to hold their babies for about 2 days. The change in blood flow also causes swelling in the upper extremities, chest and head. This swelling usually causes extreme headaches in the first 24 hours after the surgery.
Our family would appreciate your thoughts and prayers during this difficult time.