We met on Thursday with Stephen Pophal, the Cariology Interventionist who will be performing Charlotte’s catheter procedure. He was quite adorable with Charlotte and we know she’s in good hands with her. Here’s what he told us:
She’ll go in on the 26th for the procedure. She will be under general anesthesia and will be on a breathing tube. She should be able to return home within 24 hours depending on how she fares with extubation.
As for the procedure: Dr. Pophal will snake a tiny camera through Charlotte’s artery to get a close up look at her heart. He’ll also be able to directly measure her pulmonary pressures, getting a more precise reading than what is generated by ultrasound.
What might he find? Three scenarios (in order of likelihood based on what “usually happens with truncus repairs”*):
–There is stenosis around the stitches where the conduit was inserted during the repair. To correct this Dr. Pophal would then perform a balloon procedure to dilate the area. This would be a straightforward fix that would buy time until Charlotte’s next repair.
–There is a blockage or narrowing further downstream of the conduit, in her pulmonary artery or pulmonary branches. Dr. Pophal can also dilate this with a balloon procedure, however, he says that this kind of stenosis frequently bounces back (rubberband effect), so the fix might not last as long
–There is no blockage, rather, continuing pulmonary pressure. This would have to be dealt with in some other fashion (oxygen, medication….)
We really don’t know what to expect. Frankly, neither of us walked out of the consult with the “warm fuzzies,” though we quite like and trust Dr. Pophal. We’re hoping it’s the first scenario and that a balloon procedure will get Charlotte healthfully to the next repair. For now, we wait until the 26th with a bit of trepidation.
*As my wise mother-in-law notes, given the rarity of TA, there is no “usual” really. Fingers crossed, prayers said.