3rd Echo

On Tuesday, October 28, we had our 3^rd fetal echocardiogram with Dr. Van Gundy. When he was done with the echo, he looked up the z-score for Caden’s aortic valve. He came back and told us some good news. First, he said the VSD (the hole in the septum in the heart) was closing which meant that more of the blood was being forced in the correct direction which meant the aortic valve was growing. The z-score went from a -4 to a -2!!! We were very excited about that. And, if the VSD closes completely, it means that the aortic valve will probably continue to grow.

However, after telling us that news, he also told us that the mitral valve was too narrow and it’s z-score was -3.7. Neither Greg or I remember anything about the mitral valve being wrong. Our guess is that they didn’t mention it to us because everything else looked so dismal, it was of minor concern. We’re not entirely sure. But, Dr. Van Gundy is very optimistic that things can continue to change and improve throughout the rest of the pregnancy.

We went into the appointment with a list of questions for Dr. Van Gundy specifically regarding location of delivery. We had received various information from different people and wanted to talk to him about the options to see what was really realistic or not. We asked him if there was a possibility of us being able to deliver at Sutter Memorial which is downtown Sacramento. He ruled that out immediately indicating they don’t have a pediatric cardiothoracic surgeon so it was just not an option at all. Next we talked to him about UC Davis Medical Center which is also in Sacramento. He has a lot of personal experience with UC Davis and his feeling was that they were simply too conservative to deal with Caden’s hypoplastic left heart problem and the diaphragmatic hernia at the same time. Then we talked to him about Loma Linda University Medical Center. He said their bent is toward transplant, not repair and that creates its own set of problems such as not getting a heart in time, anti-rejection drugs, increased risk of tumors, another transplant within 8-10 years, to name a few.

So, hands down he felt Stanford was our very best option. He really felt they were best equipped to deal with the heart defects and the diaphragmatic hernia. However, that being said, we talked to him about his feeling of the odds of viability even after surgery. He said as things are today, he is an optimist and would put the odds at around 50% survival rate. Of course, if things with the heart continue to improve, the odds of survival would probably improve as well. And, several people have asked us why we haven’t talked about in-utero surgery. It is just not an option for the situation we are in. Dr. Van Gundy said there is no possibility of that at all.

Anyway, we left the appointment feeling very positive about the improvements in the heart conditions that we knew about (VSD & aortic valve). But we also left with some new concerns such as the mitral valve and one of the arches. We continue to seek the Lord in prayer and try to go in the direction he leads us. We felt that several doors closed this week which makes some of our decision easier. But, of course there are still several more weeks to go and we want to continue to pray for guidance and direction.