Heart of the Matter, Part 2

The Echo

A few weeks ago I finally had the fetal echo(cardiogram) that I mentioned in my first Heart of the Matter post. The echo is simply a sonogram in which they look at the heart in detail.

My wonderful boyfriend was able to make it to this appointment, and I was very thankful for that. Since he lives so far away, this is only the second appointment he has been to. We knew the doctor could potentially tell us serious news about our daughter's heart, so there was a lot of anxiety walking into the ultrasound room....now a very familiar place to me.

As usual the technician began the appointment by squeezing the warm gel onto my ever growing baby bump. She picked up the wand, and in a few seconds little Pippa appeared up on the screen. The technician did her best to make us comfortable as she went about her assessment. The small talk was not enough to keep me from wondering what every click she made meant.

After about a half hour of taking all sorts of pictures and videos of our girl's heart, she left the room to get the doctor. He came in and picked up the wand, then began repeating a lot of the same things the technician did. As he was doing so, he and the technician exchanged medical talk that was beyond my understanding.

21 week sonogram... Pippa salutes!

Suddenly, I became very flush and lightheaded. I am not sure if it was the anxiety of the appointment, the now forty-five minutes of pushing and prodding by the sonogram wand, Pippa's kicks and punches back at the wand which was apparently disturbing her, or all the heat being generated by the equipment, but I felt as if I was about to either vomit or pass-out. The technician obviously noticed my discomfort, which I was trying to hide so the doctor could finish up. She began to fan me with a folder she was holding and I rolled onto my side a bit, which marginally alleviated some of my dizziness.

The doctor finished up quickly, and I slowly began to regain my composure. He then started to tell us what he had seen. Unfortunately, he didn't have any conclusive answers. The doctor told us he was suspicious based on what he saw that there was a heart defect, but the heart was still too small for him to be sure and make a definite diagnosis. He referred us to a pediatric cardiologist, and said we should schedule with him in approximately three weeks.

That appointment was on Friday.

Another Echo

It progressed very similarly to the first echo, although I was alone at this appointment. The faint feeling even returned about thirty to forty minutes into the echo. From this I conclude that anything over a half hour is too long for a sonogram. Luckily this time there was a tower fan in the room, and once this was turned on and pointed directly at me I felt tremendously better.

Unlike the first exam, however, the cardiologist had answers for me about what is going on with Pippa's heart. It was not the news I was hoping for, but the news I had been bracing myself for.

The Diagnosis

The doctor told me that based on what he saw, he is quite certain that Piper's heart has an AV Canal defect. As I mentioned in the first Heart of the Matter post, this is the most common heart defect in babies with Down syndrome. What this means is the septum of the heart (the part dividing the two left chambers and the two right chambers) is not complete. Also, there should be two separate valves between the top and bottom chambers (the atria and the ventricles), but due to the incomplete septum there is just one large valve. This defect allows for co-mingling of the blood returning from the body and the blood returning from the lungs.

 

Normal Four-Chamber Heart
 



Heart with AV Canal Defect



Pippa will need open heart surgery around two to six months in order to fix this defect, but the doctor explained that the defect will not affect the rest of my pregnancy or her birth. The doctor also assured me that the surgery has an extremely high success rate, and her Down syndrome will not increase the risk of the surgery.

Even so, I cannot help but be worried about what the future holds. I am trying to just relax and take it one day at a time, but the thought of my little girl undergoing such a serious surgery at such a young age terrifies me. I know that Piper Grace is a fighter already though, and she is strong like her momma. In the meantime, all I can do is stay calm and carry on.