1. Surgery went well. Dr. M is pleased with the outcome in terms of structure.
2. In terms of function, Elliott has develop a very dangerous complication- an arrhythmia that has been periodically popping up. Basically, the atria should pump, to load the blood, then the ventricle pumps to deliver the blood to the lungs or body. During this arrhythmia, Elliott's ventricles are pumping first. Essentially, the ventricles are pumping faster than the atria. So the ventricles are squeezing without having received the blood- like a well pump in a dry well. To mitigate this, they are keeping him cool, closely monitoring blood pressure, and the have pacing wires and a pacer that is set to pace the atria faster than the ventricles. As long as his junctional rate stays low, this is relatively easily managed with the pacer. So far the pacer has been adjusted quite a bit, in search of that sweet spot. It has gone from 155 to 145, back up to 165, and it is currently down to 140. Now, it is not suspected that this is due to any damage, per se, to the conductivity hub of the heart per Dr.M and the electrophysiology consult. It is more likely related to the trauma of major surgery and resultant edema. Therefore, we expect that the pacing wires will be removed sometime in the next few days.
3. Dr. M was in to check on Elliott this morning. He was pleased with his current status. He said that the next few hours to the 24 hour and then to the 36 hour mark are critical. Blood pressures tend to drop, as the effects of having been on bypass begin to appear. During this critical period, Elliott's blood gases, cerebral profusion, kidney function, etc will be very closely watched. He is also expected to remain on peritoneal dialysis to help out his kidneys and flush toxins from his blood as a preventive measure for the next 24 hours or so. The team will be continually monitoring his condition and adjusting his medications accordingly. This is an expected part of pediatric cv surgery.
4. I will try to be sure to update when I have news. Thank you all for your continued support. I am adding pics below. While it is really difficult to see our little man like this, please know that he is not in any pain and take comfort knowing that he will have no memory of this adventure. Of course, we will share these posts with him when it is appropriate- as Dr. M says "to help him understand why mom and dad are so crazy protective."
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