Update on Sariah Jane Boseman

May 08, 2007 at 08:18 PM CDT
We have great news to relay to everyone. We met with the cardiologist again this morning. The short version of the story is that everything that we have hoped and prayed would happen with her heart is what the cardiologist told to us this morning. Her heart and circulation have developed in such a way that she is now breast feeding like a champ and may be discharged tomorrow. We have not talked to a surgeon yet but she may not need any surgery for 4-5 months. There is a good chance they would be able to do a surgery at that time that could correct some of her abnormal heart anatomy and blood flow to the lungs. There is also a chance they would do only part of this major surgery at that time and finish with another surgery later on in life. Either way, we know that Heavenly Father has anwered the many prayers for her. We are very thankful for this extremely good news although we know there are still many challenges ahead. For those that feel medically inclined and would like to know more, read on. I have also included a couple of web links that describe her problem a little bit better. The things that have developed in her favor are: 1)She has a well developed central pulmonary artery trunk with both sides connected (this is often undeveloped). This trunk is supplied by collaterals (newly grown blood vessels that don't normally develop) from a left shoulder artery (her subclavian) and her aorta (the large artery leaving her heart). 2)Most of the collaterals seem to feed into the central pulmonary trunk. This means that a shunt can be placed from her heart to the pulmonary trunk. This should allow normal blood to be supplied to most of her lungs. In many cases, the collaterals are much more tricky and do not go through the pulmonary trunk. 3)Her collaterals are so extensively developed that she has never really required oxygen or been blue except the first few moments after birth. 4)Usually having such extensive collaterals implies you will have a poorly developed pulmonary trunk. In Sariah's case, she has both collaterals that feed the pulmonary trunk and collaterals that feed the lungs on their own. This gives her an extra oxygen supply accounting for her doing so well right now. Over time many of the collaterals will shut down, but she will have surgery restoring normal blood flow to the pulmonary trunk prior to this so it should not be an issue for her. The other hurtle for her will be determining whether or not the large hole between the two ventricles (VSD) can be closed without overstressing the heart. Pulmonary Atresia with VSD - Heart anatomy Pulmonary Atresia with VSD - picture tutorial
2 May 07, 2007 at 10:07 PM CDT
Today was a full day. Sariah had a cardiac angiogram to look at the blood vessels of her heart and lungs. She had to have general anesthesia for the procedure. She had to go without food from 4 a.m. until her procedure at noon, a trial she bore gracefully. The procedure went very well. The cardiologists were able to get enough information that we will meet with the cardiac surgeons tomorrow to discuss management options. She was very slow waking from her anesthesia and mom and dad breathed a sigh of relief when she finally took a binky treated with "Sweet-Ease" at 10 p.m. If Grandpa Boseman had been here he would have probably tried spiking her binky with Sprite and got her to wake up a lot sooner.
1 May 06, 2007 at 11:22 PM CDT
Sariah Jane Boseman arrived on Friday, May 4th 2007. She was born at Methodist Hospital, Mayo Clinic's OB hospital, in Rochester, Minnesota. She got off to an exciting start. Liz was induced 4 days before her due date, May 8th in order to facilitate testing on Sariah's heart. Liz progressed much more rapidly than expected and ended up delivering just one hour after starting an IV induction medicine (8 hrs after arriving in the hospital) and as such she was unable to receive her epidural. She shocked her doctor, husband and everyone else caring for her. The actually delivery was uncomplicated. Sariah came out looking beautiful although a little blue but quickly pinked up. She received a priesthood blessing from her dad and one of his friends and was then transported to Saint Mary's Hospital to the Newborn ICU while mom had to stay behind. That night Sariah had another echocardiogram where we learned that she has a condition called pulmonary atresia with ventricular septal defect (PA-VSD). Basically, the blood vessel from her heart to her lungs did not develop and instead her lungs are being supplied by alternate vessels that come off of her aorta, the other main vessel from the heart that supplies blood to the rest of the body. She is getting enough blood to her lungs right now that she really is not having any problems. In fact, she is eating well on her own and requiring no sort of life support. The other component is that she has a large hole between the two pumping chambers of her heart (VSD). This means the unoxygenated and oxygenated blood in her heart can mix together whereas it normally stays separate. This makes the heart less efficient and forces it to work harder to do the same job. This little heart of hers has a very complex problem. Liz made a rapid recovery and was discharged from the hospital Saturday morning. She has been breast feeding since then and is doing very vell. We really appreciate Gramma Boseman's help with caring for the other children. We know all of you have been praying and thinking about us and also greatly appreciate that. Tomorrow is a very big day. She will have an angiogram of her heart and blood vessels to try to better define her problem and figure out what needs to be done next. She has been blessed by all of the faith and prayers of everyone thus far.