On October 10th Samuel saw Dr. Colvin at UAB. He did an echocardiogram and chest x-ray while we were there. It was determined that Samuel has a single ventricle, double inlet to the left, transposed great vessels but no obstruction in outflow to the aorta or pulmonary artery. They think his ductus is patent as well. He has saturations that are about 90% and he is not in overt heart failure which suggests that he has at least some restriction in blood flow through the distal pulmonary vascular bed and almost certainly has important pulmonary vascular disease at this point. Dr. Colvin is not sure that surgical intervention is in his best interest. They want to further evaluate his physiology in the cath. lab. If they determine his ductus is patent and that he has fairly brisk pulmonary flow, it may be possible to consider a left thoracotomy with ductal ligation and pulmonary artery banding as a prelude to later interventions to try and deal with the single ventricle. His anatomy is such that one could consider a septation operation for his ventricle though these are infrequently done in this area. They doubt he would ever be a candidate for a Fontan operation.
The problem with thoracotomies or sternotomies for Samuel is that they may make him a less optimal candidate foe eventual heart/lung transplantation. They will keep this in mind as we make plans for any intervention.
For now we have started immunizations with our pediatrician, Dr. Jim Rabon. On Friday, Samuel got a flu shot, three immunization shots and blood drawn. He was not a happy boy, but recovered quickly. Once his blood work returns and we know his renal function is normal, he will begin taking Digoxin to help his heart pump stronger.
We have great respect for Dr. Colvin and plan for him to be our local cardiologist, but felt we should get a second opinion.
We have been fortunate to get an appointment with Dr. Mee, a surgical cardiologist at the Cleveland Clinic in Ohio. Currently, our appointment is set for November 15-17, 2005. If he has a cancellation, it could be sooner. Blood work will be done on the 15th, heart cath. on the 16th and if surgery is needed it will be done on the 17th. Dr. Mee is considered one of the top cardiac surgeons in the world and will be retiring shortly after our visit. God opened this door thru Dr. Robert Savage, a family friend and co-worker to Dr. Mee. I continue to put our trust and hope for healing in the ultimate healer, God! We will keep you updated if anything changes. Continue to pray for healing of his heart, weight gain (he now is at 23 lbs.), reassurance in his mind that we are not going to leave him. Thank you all for your continued support and prayers.