Finally.... Emily's Echo Results

I heard back from Emily's cardiologist on Wednesday and the good news is that she does NOT have a heart murmur. Dr Armsby said her heart is beautifully formed, normal, and healthy. The problem is her PDA (Patent Ductus Arteriosus - see posts back from the NICU days) that they thought had closed....either didn't or is open again. If it did re-open it happened either during the NICU or shortly after. (GRR!) Emily isn't showing typical symptoms of a baby with a PDA so it's a pretty mild case which explains why it went un-noticed for at least 5 months.

What's a PDA you ask. This is a vessel in the heart that is open while in utero for all babies and once a baby is born it should close – full term almost always closes – in preemies it takes a while or medical intervention is needed. They can be given medicine or have it surgically repaired - both having risks associated with them along with the fact that it is usually on a very tiny or sick baby. Back in February our NICU Dr chose the wait and see method since Emily seemed to be doing well - it took her about 3 weeks. If she had started to have problems or if it didn't close a few weeks later she would have had to have either the drug or surgery and she would have been about 2lbs at the time. NO THANK YOU! We were very excited when it appeared to have closed on it's own. Here's a quick diagram showing a normal heart and all the valves & vessel and what a heart with PDA looks like.

The problem with having a PDA is that the blood should be circulating from the lungs throughout the body but with this PDA duct that should have closed actually it shunts the blood from the lungs to the heart and back into the lungs. Over years (Many Decades) it can cause stress to the lungs & heart. And there is a chance that the open vessel can get infected which is rare but would’t be good.

PDA Info
http://www.healthsystem.virginia.edu/uvahealth/peds_cardiac/pda.cfm


Short term, our Dr said there’s nothing to worry about but at about a year in age or 16lbs she’d like us to come in for another Echo. If the Ductus is still open (which it’s pretty likely it will be) they will do a surgical procedure. There are a few options:

• Surgical incision on the side of her body under arm – go in and close off the open ductus/value. Definitely put to sleep, maybe ventilator (but not sure – the next option makes me think this is the case), stitches on outside of body.
• Cardiac Catheterizing – go in through a catheter in Em’s leg and put a coil around the ductus. 1 hour procedure, breathing on her own, home the same day with a band aid. Minimally invasive, has risks but is likely the path we’d go. http://www.daviddarling.info/encyclopedia/C/cardiac_catheterization.html

So now we just need to keep an eye out for Emily to either not gain weight as expected or not be able to kick a cough or cold. If she continues to have respiratory illnesses (which is common in all babies especially during this time of the year) and can’t seem to get healthy it would make the Dr want to do the surgery sooner.

So, in a way I think this is good news. She does not technically have a heart murmur and I’m very thankful and happy that we didn’t have to surgically close this while she was a tiny baby which could have very likely been the case. They like to do these surgery’s between 1-3years so I feel that the bigger she is the better off she’ll be.