This month, we are ten months post-Nikaidoh. (Yesterday was his ten month anniversary, actually.)

Thursday Chase had his first cardiology appointment since October of last year – 6 whole months without a visit to the office! That’s some crazy stuff, folks.

I wish I could say it went exactly as expected (“Hello! Looks great, see you again in six months!”) but that unfortunately wasn’t the case. The echo-cardiogram picked up increased pressure on the left side of Chase’s heart; it seems that his conduit is narrowing. Normally they don’t expect to see this until 5-10 years post-surgery, due to buildup or just because the body is outgrowing the bovine tissue. However, since it’s only been ten months this is pretty obviously not the case. The pressure increase is pretty drastic, and there’s just no way that scar tissue or calcium could build up fast enough to cause it. (Right after surgery, Chase’s pressure was at 7 mm. 0 mm is a “normal” heart, but 7 mm is very good for a heart with a conduit. At his next appointment pressure was at 36 mm, which was sort of a jump up but still within normal ranges. This last echo picked up pressure of 80 mm. Definitely a big jump, and definitely out of “normal” ranges.) We were told that occasionally a kink develops in the conduit, which could be what’s happening here. 

At any rate, an echo-cardiogram is not the most reliable way to measure this particular issue, so it’s been recommended that we head up to Atlanta sometime in the next couple of weeks for a catheter procedure. It would take a look at what’s going on, and say either “Oh, there’s narrowing but the echo was waaay off. No intervention needed right now!” and off we skip. Or they could say “Hmm, yup, this narrowing is severe enough that we really should just go ahead and take care of it now, since we’ve already got you here and everything.” If we’re being realistic, the chances are that we’ll hear option #2. Probably the narrowing won’t be quite as severe as 80 mm because Chase isn’t showing any of the symptoms you would expect (loss of energy and appetite, possible fainting spells, and pressure on the heart wall.) But something definitely changed enough for the echo to pick up on it, so we’re expecting some sort of intervention to happen at the appointment as well.

Of course, since we don’t know how narrow everything is or why, we really don’t know what they will do to fix it. More than likely they will either perform a balloon catheter to expand the conduit, or they will place a mesh stent in the conduit to keep it open. The good news is that these procedures are fairly in-and-out; if they place the stent they will probably keep us overnight for observation but otherwise we can expect to go home that same day. Our cardiologist also assured us that although this is not something they expect or like to see so soon after surgery, since the Nikaidoh is so new it’s not totally unexpected to encounter these sorts of “road bumps”, and he doesn’t expect it to affect the long-term outcome. 

Although hearing all of those things is reassuring, it would be a lie to say that we aren’t worried. We hate to bring Chase back to the hospital soon, and would appreciate any good vibes/prayers you guys could send our way. And of course, we will keep you updated as soon as we know more. 

          xoxo,

                     Sammy