Developing plan of attack

Olivia was just visited by a herd of MD's and Students during morning rounds. Echo will follow sometime today with an MRI tomorrow. There is the possiblity that as long as she does have good collateral bloodflow to the lungs, she might not need the initial shunt surgery. If that is the case and all else goes well, she would go home for observation and to grow to get ready for surgery at a later date.

Since a lot of the severe defects like this tend to group with other diseases they will test her for a number of different syndromes that are sometimes associated with her Tetralogy & Pulmonary Atresia defect. The two big syndromes being named are DiGeorge Syndrome  or Alagille Syndrome. Genetic tests have been sent out for DiGeorge Syndrome and I think they will sumbit samples for Alagille also.  

In quick consultaion with the Gastroenterolgist today, he does not believe that Olivia has any major Liver or Bilary disfunction. He did put in a request for some additional labs and a Liver Ultrasound to make sure. He believes that her liver function elevations are secondary to her cardiac issues.

The Echocardiagram has been done, but ahven't talked to the Dr's yet about results. Will post when available.