At our first appointment with him, he had trouble even finding the tricuspid valve and said that if it was there, it was so small that he couldn't see it. At an appointment last week, Dr. Atkinson mentioned that he thought he saw that valve now, so I was anxious to hear what Dr. Robinson (the cardiologist) thought. Harper was in a very cooperative mood, which made things so much easier and Dr. Robinson was able to get a really good look at her heart.
The Tricuspid Valve is definitely there, but it's on the small side. It should be measuring about 9mm at this point, but it's somewhere between 4 and 5 mm. There is still time for it to grow though, and that's what we are praying for. If the tricuspid valve grows, then our biggest problem is the hole in her heart, which can be patched after she's born. It's only because of this hole that Harper's right ventricle (the lower right chamber of the heart) has grown and developed, but it will cause heart failure after she's born if it's not fixed. This hole is quite large as far as holes-in-the-heart go, but it's not too large at this point that it couldn't be patched. If the hole gets any bigger, it will be less likely that they will be able to patch the hole to make a two chamber heart.
So we're working with two variables here: the size of the hole and the size of the tricuspid valve. We need the tricuspid valve to grow and the hole in her heart to not grow (shrink would be even better, but I'm told that's not realistic...that won't stop me from praying for it though.)
These two variables will determine everything about our plan of action. Here are a couple scenarios that could play out:
1. If the tricuspid valve does NOT grow and/or the hole DOES grow, then we will most likely continue with our original plan to do the PA Band surgery the first week of life and then two other surgeries later on to make Harper's heart into a one-chamber heart. This will mean three surgeries her first two years.
2. If the tricuspid valve DOES grow and the hole does NOT grow, then we may or may not do the PA Band (depending on how her heart is functioning at birth) and she will undergo a surgery anywhere from 2 months to 6 months to separate the heart into a two-chamber heart by patching the hole in her heart. This will mean 2 surgeries (but possibly even just one). A good two-chamber heart is better than a one-chamber heart, but an excellent one-chamber heart is better than a bad two-chamber heart.
Scenario #2 would be a better situation for Harper because it would be 1-2 less surgeries and would leave her with a two-chamber heart, but either way, we are optimistic that her heart is fixable and she will be a healthy little girl after this is all said and done.
She still has a couple months to grow and even though we won't see the cardiologist again until she's born, Dr. Atkinson will be looking at her heart every week and making sure her growth remains normal. If everything continues to go well, we will probably deliver the first week in April and it's going to be quite the party with all of the doctors and nurses that will be there. Harper will certainly be making a grand entrance into this world. I'm anxious to meet this sweet thing that has caused us so much worry already!
We are so pleased with her growth and development and so thankful that God continues to move things in a direction that is more hopeful and positive for our family. Thank you again for your prayers and thank you for checking on us.
Here is a picture from last week:
(28 weeks pregnant)
And here are some pictures of the most precious boys I know. I think Harper is one lucky little girl to have Eli and Landon...although I'm a little concerned about her surviving them her first year or so :)
I guess she'll be tough!
I'm looking forward to a nice, productive weekend at home with my three favorite people. We've been very busy with potty-training and I plan to report on that soon. It's nothing short of frustrating, gross, and hilarious. Most likely I'll be telling you what I've done as a "how NOT to" guide. Despite it all..we are making a little progress. Emphasis on "little"!