|Waiting to go, watching Mommy's phone.|
Just after eleven Dr Hanley stopped by to see us and introduce himself. Gabriel's previous surgeon, Dr Reddy returned to UCSF and left us with a choice. Do we follow Gabriel's amazing surgeon to a new hospital or do we stay at an amazing hospital and go with another surgeon? Fortunately Dr Hanley is on par with Dr Reddy as one of the top surgeons in the world conducting surgeries on what many other surgeons consider inoperable cardiac kids.
Dr Hanley told us Gabriel was prepped and they were almost ready for him (Dr Hanley) and assured us they would take good care of him. He would try not to use the heart and lung machine, but it was there if necessary and he preferred to act conservatively and use it if need be even though recovery time would be extended. I told him we knew Gabriel was in the best hands and Beth asked if she could give him a hug and they hugged.
So about five and a half hours after reporting in he was undergoing surgery. The Fontan procedure requires the surgeon to open the chest which evidently is more difficult this time as it has been done twice before and is full of scar tissue. Once the chest is open the surgeon removes the inferior vena cave from the atrium and connects it directly to the pulmonary artery (all of this was done three years ago during the Glenn procedure with the superior vena cava). At the end of the Fontan Gabriel's cardiopulmonary function is quite unique: his right ventricle pumps blood out to perfuse the body via a recombined aortic arch and the blood returns directly to the pulmonary artery, passively moves through the lungs and returns via the pulmonary vein into his atrium, dumps into the ventricle and repeats, on ventricle, one atrium. His oxygen concentration increases but pressures drop (which create other problems he will address in life but that's something else).
Two and a half hours later, about two pm, Dr Hanley met with us and told us everything had went smoothly and they did not need to go on bypass (heart and lung)! He said they would have him upstairs in the CVICU (cardiovascular intensive care unit) in less than an hour and after they had Gabriel settled in up there we would get to see him!
Long, long day.