Tuesday evening

Well, Emma Kate is through with surgery and is now in the cardiac ICU. She got into the OR around 8am (after waiting in the prep area for over an hour... with a not-too-enthusiastic-two-year-old, it was a bit challenging). We got to stay with her until they gave some versed- she got quiet, then just started giggling... it was really sweet. She didn't mind at all when we had to hand her off to the nurses. They kept us updated on progress fairly regularly through the procedure, and by 3:30 or 4pm, the two doctors came out to talk to us. She did well through the surgery, but there was an awful lot of scar tissue from the first operation. It took them a LONG time to carefully dissect everything out and leave minimal damage. They enlarged the insertion of the left pulmonary artery first, using a pericardial patch (fancy that...) and splitting on the opposite side, and now it is slightly bigger than it would naturally be. They don't expect any future issues with it but it will be monitored regularly. Then they addressed the airway- they performed a slide tracheoplasty and they were able to do it they way they preferred as far as where it attaches front to back. They did end up leaving the patch in place, and she's left with a short airway that has 3 tubes at the bottom instead of two- her pig bronchus comes off down at the carina now, along with the two mainstem bronchi. There is a bit of a "figure 8" to her trachea now, which is often expected with these, and they don't think it will be a big issue. Unfortunately, there was so much scarring around her left recurrent laryngeal nerve, and with all the manipulation it has endured with the two procedures, they suspect there is damage to it (likely permanent) and that she will have paralysis of her left vocal cord. They have assured us that there is a good likelihood that she will compensate for it and that we might notice a hoarse voice and there is a potential for some increased swallowing issues until the compensation is established. Apparently children compensate a whole lot better than adults do for this issue.

So she is set up in the cardiac ICU for the night with hopes of extubating tomorrow as long as she "behaves herself." Lets hope she does and the healing can begin.