- Ventilation scan
- Cardiac Catheterization
The ventilation scan is just to give extra information before going into the cardiac catheterization. The bronchoscopy is a visual inspection of his airway to make sure it has good integrity and function. The bronchoscopy will be done opportunistically, since he'll already be heavily sedated by an anesthesiologist (try scoring that word when playing scrabble or hangman!). The major procedure of the day is the cardiac catheterization.
The cardiac catheterization will mainly be an exploratory surgery, with possible interventions taken to repair his pulmonary vein stenosis. The procedure will feed a tube through his leg artery, into the right atrium of his heart (labeled as "RA" below), through to his left atrium (labeled as "LA" below), and then into the pulmonary vein which has narrowed (shown darkened on the middle left below):
As mentioned in some previous blog posts, Dr. Moore and his team will first perform some exploratory measurements to see how effectively the oxygenated blood is received from Roscoe's lungs through his pulmonary vein. They will also measure the effectiveness of various treatments for chronic lung disease (such as nitric oxide, sildenafil, and maybe some other drugs).
After the measurements are performed, Dr. Moore will consult with his team and determine (based upon their collective experience) what will be the proper treatment for Roscoe's pulmonary vein stenosis. The first option will be to place a small balloon inside the narrowed vein, inflate the ballon, then deflate the balloon and see if the vein stays open. If that doesn't work, then the next option would be to place a stent (expandable rigid mesh tube) inside the narrowed vein. They would use the balloon to increase the diameter of the stent, then leave the stent in place in Roscoe's heart. Eventually, Roscoe's vein would grow new tissue and bind itself to the stent (making it very difficult to remove). There are various types of stents that the team will have on hand, and they will choose the most appropriate type based upon what they find during the exploratory phase of the procedure.
The last option will be surgery, if the prior two options fail. We've heard varying opinions, but it seems like the surgery is only appropriate once kids are at least a few years old, and even then it is very risky (since they need to stop both the heart and blood flow to the heart).
Our hope is that God will grant these doctors wisdom to choose what will give Roscoe the best possible outcome (and with God, all things are possible). If the doctors are able to repair Roscoe's pulmonary vein stenosis, then it will make his chronic lung disease (his other major issue) much easier to treat, since it will open up more common options for treatment. Please pray fervently with us that Roscoe's results are fantastic and that this is finally the start to the healing we have been longing for.