Lessons of the Heart

With one week to go before Grace's surgery, we wanted to take the time to get specific.  Grace has two primary heart defects, a complete AV canal defect and Tetralogy of Fallot.  These both require surgical intervention, and will both be addressed next Tuesday.  If the anatomy lesson is too much for your brain, please scroll to the bottom to know how best to focus your prayers and intentions for Grace next week.

The normal heart has 4 distinct chambers, with a clear separation between right and left sides and 2 distinct vavles between the right upper and lower heart and the left.  It looks like this:

Grace's heart has a large hole in the center of it, so there is no separation between the right and left sides, and there is one large valve between upper and lower rather than two distinct valves:

Next Tuesday, Dr. Spray will place a patch in the center to clearly separate the right and left sides of the heart.  This will ensure that oxygenated and deoxygenated blood don't mix.  This patch will miraculously become part of Grace's heart, as her tissues grow around it and strengthen the right/left divide.  Dr. Spray will also take the one central valve and create 2 separate valves:

In addition, Grace has Tetralogy of Fallot.  This defect results in the right ventricle (the lower blue section) becoming too thick and pushing on the pulmonary artery - the artery that takes blood to the lungs to be oxygenated so it can then go out to the rest of her body.  In addition, her pulmonary artery is defective in that the valve that paces the blood going from heart to lungs is too narrow.  In order to fix this, Dr. Spray will need to thin out the muscle of the right ventricle so it doesn't push on the pulmonary artery, and he'll need to gently open up the pulmonary valve:



Interestingly, this Tetralogy defect has helped her cope with the hole in her heart by slowing the rush of blood to the lungs, one of the big complications with AV canal defect.  So while having a second defect to repair doesn't seem like a blessing, it has been for Grace in her ability to thrive as she has these first four months.

With any surgery, there are risks.  This surgery will be no different.  There are a few specific things we'd like to ask you to focus your prayers and healing intentions toward: 

1.  The center of the heart, where Dr. Spray will be placing the patch, is the same section of the heart where the electrical wiring of the heart resides.  This electrical tissue looks no different than any other heart tissue, so there's a chance it could be nicked in the surgery.  If this happens, Grace will need a pacemaker for the rest of her life.  Please pray that Dr. Spray's knowledge and intuition will allow him to spare this delicate tissue.

2.  The 2 valves that Dr. Spray and his team will be creating should function efficiently, but sometimes because of the small size of the heart, they become leaky and require additional surgery.  Please focus your intentions for these valves to function efficiently so that no additional surgery is needed.

3.  The pulmonary valve that needs to be widened is delicate, and if it is widened too aggressively, or if it is too adhered, there is a chance they'd need to remove it and put a replacement synthetic valve in.  This synthetic valve does not grow with Grace, so it would require surgeries every 5 years or so.  Please pray that her pulmonary valve can be spared and made functional without the need for a replacement valve. 

While all of this seems completely scary, we are in awe that the technology and skill exists to allow such repair. In addition, every time we look into Grace's eyes, we see such a strong soul, and she reassures us that she can handle this.