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Monday, January 26, 2015

Cath Lab Drama

Caroline had a pre-Fontan heart catheterization the first week of December that I was NOT prepared for.  Instead of having an outpatient procedure to measure her pressures, coil off any collateral veins, do any stinting...I got a call from a nurse in the cath lab about 15 minutes after I left her there. (As a side note, leaving a child on the table for ANY procedure is difficult.  Even after a healthy dose of Versed, she fought the mask on the cath table. Then, as her body was taken under by the anesthesia, she shook violently like she was having a seizure. I was prepared for this. It wasn't easy, but I had a very good idea of what to expect.)  My phone rang just as I sat down in the courtyard with a Coke.  The nurse asked, "Has Caroline ever had any issues with heart block?"   Ummmmm. What?! That just SOUNDS bad.  And the answer is NO!  Of course, I start researching on Google as soon as she hangs up.  I head back down to the overcrowded waiting room and wait in a rude impatient way, pacing in front of the receptionist, face glued to my phone.  They finally call me and request a meet up to discuss 'details' of the procedure. Apparently, as soon as she was under anesthetics her heart rate began to tank (low 30's, high 40's), and she went into a 2 to 1 heart block.  They brought her directly into the VERY full CICU at LPCH for observation. Our goals were to watch and see if her blocks were causing blood pressure anomalies or pushing her oxygen saturation to unsafe levels.  Despite the almost 36 hours we spent there being observed, her body never responded negatively in heart block. The doctors still recommended placing a pacemaker when we do the 3rd stage palliation (Fontan).  I don't agree.  We are seeking the opinions of other institutions.