Autumn's Heart

What We Know About Autumn's Heart

According to the most recent echocardiograms (specialized ultrasounds for looking closely at the very small hearts of babies in the womb), we have a pretty good picture of what is happening in Autumn's heart.



After three echocardiograms, the cardiologists have agreed that Autumn's heart is displaying the symptoms of Tetralogy of Fallot. From what we understand, there are two major problems with a heart displaying this condition. 

1. Ventricular Septal Defect (VSD) - This is a hole in the wall that separates the two lower chambers of the heart. Normally, one chamber of the heart pumps only red blood to the body and the other side of the heart pumps only blue blood to the lungs. However, in Autumn's case, her red and blue blood is mixing which could cause the lungs to work harder and become congested.

If this were the only issue in her heart, we could probably wait to see if the wall would repair itself in the first weeks of life. The other intervention would be a surgical patch to keep the blood separate. The second major issue (the pulmonary stenosis) is what is making this a much more serious situation.

2. Pulmonary Valve Stenosis - The valve that pumps blood from Autumn's blue chamber to her lungs is very small. At the moment, the cardiologists think the valve is not pumping any blood to the lungs (which luckily for Autumn, is not a problem as long as she is still getting her oxygen from me via the placenta). This stenosis (narrowing of the valve) will become a serious problem when she is born because she will need to start relying on this pulmonary valve to send blood to her lungs. The valve will most likely not work and she would not have oxygenated blood to send to her body.

The Amazing Interventions of Modern Medicine

Although the VSD and Pulmonary Stenosis could threaten Autumn's life within the first 12-24 hours of being born, the medical team at Texas Children's is very prepared to intervene immediately and prepare to surgically fix the problems in her heart. 

First Intervention
The physicians will start Autumn on prostaglandins - a medication that will keep the Ductus Arteriousus (the blood vessel between the pulmonary artery and the aorta) open. This is an incredible little blood vessel we all have that helps the process of pumping blood through our bodies while our lungs are full of fluid in the womb. 

By keeping this blood vessel open, the surgeons will have time to check Autumn's heart and blood flow for a few days with more accurate echocardiograms performed directly on her. They will be able to determine the exact state of the heart and then move forward with the next intervention.

Second Intervention
Within the first week, Autumn will most likely have her first surgery. A temporary shunt from the Aortic Valve to the Pulmonary Artery. This will temporarily solve the problem of pumping oxygenated blood to her body until she grows big enough for the third intervention. 
 

Third Intervention
As long as she is growing and eating and looking healthy, when Autumn is 5-6 months old she will have her third major intervention. The cardiologists expect to close the VSD (hole in the wall) with a patch and insert a conduit between the right ventricle and the pulmonary artery to serve the role of pulmonary valve. This intervention will allow Autumn to have a relatively normal childhood with regular cardiologist appointments to make sure the repairs are working. She may need additional surgeries as she grows and her heart grows with her.





This is our knowledge as of now. The cardiologists seem to be pretty confident with this diagnosis and expect the surgeries to go well. All of this, of course, has a level of uncertainty and we will have to face each change and challenge as they appear. At the moment, we feel grateful that this was caught so early in the process so we could prepare to provide Autumn with the best interventions possible. We will continue to have faith and pray for strength to navigate through all the ups and downs surgeries and uncertainties can bring.