So Let's Talk Anatomy

So what exactly does Olivia have?

I know I've linked to the general pages with some diagrams, but even in our mind its still dificult to envision exactly what's going on.

So let's start with Tetralogy of Fallot. As the name suggests, there are 4 components to this group of problems.

1) VSD - Ventricular Septal Defect  - A hole in the wall between the Right and Left Ventricles allowing mixing of Oxygen rich Red blood and Oxygen poor Blue blood

2) Thickened right Ventricular Wall -- due to increased pressures and increased work by right side of heart

3) Overriding Aorta -- Aorta has moved from the left side of the heart to the sight side sitting right over the VSD. 

4) Pulmonis stenosis  - Outflow obstruction of the Pulmonary artery coming from the right side of the heart. 

In general terms this cardiac defect allows mixing of Unoxygenated Venous Blood (Blue Blood) to mix with Oxygenated Arterial Blood (Red Blood). This decreases the amount oxygen that is delivered to the rest of the body resulting in the classic "Blue Baby" symptoms. Olivia never showed these Blue or Cyanotic signs because of the collateral circulation going to her lungs. As She aged though, she would have started showing more and more symptoms.

In Olivia's case she not only has the Pulmonic Stenosis, but she has Pulmonary Atresia where her Pulmonary Artery has actually alomost completely failed to develop. She is getting no forward outflow out of her right Ventricle. All her bloodflow is coming from her Left Ventricle.  

The Pulmonary Artery plits into right and left branches to go to the right and left lung sides. In Olivia's case, she has under developed pulmonary arteries to both the right and left side. The good news is that these vessels are continuous, ... small but continuous. 

The general plan for surgery is to place a shunt (gortex) from the top of the Right Ventricle to the junction of her R and L Pulmonary Arteries.  (I'll post a drawing the Cardiologist did a little later.