This is a blog for my daughter Scarlett. She was born with a complex congenital heart defect known as Tetralogy of Fallot with Pulmonary Atresia. She is my little hero.

Wednesday, September 23, 2009

Surgery Explanation 2

MAPCAs (Major Aorto-Pulmonary Collateral Arteries) labeled here with the letter "C" are the second reason why her Oct. 1st surgery is so complex, challenging, difficult and will take all day. Evidently, normal people like you and me do not have MAPCAs, but it is very common for patients with Tetralogy of Fallot/Pulmonary Atresia to have them.

I am no doctor, but from what I've read [internet education], when the heart doesn't have a pulmonary artery to send blood through, it compensates by creating tons and tons of tiny collateral arteries instead. MAPCAS are practically useless little veins connected to your heart.

For Scarlett, Dr. Cleveland will have to implant the homograft (conduit) and test pressure in her right ventricle/existing tiny pulmonary arteries. If the pressures are too high, he *might* cut off several of her MAPCAS, bundle them together, and relocate them to another area in her heart where they will be more useful (its called unifocalization). This is obviously tedious and time consuming, and Dr. C has to be careful, meticulous, and calculating. (God Speed to Dr. Cleveland).

Also from my internet research: "The management of infants and children with pulmonary atresia, ventricular septal defect, and multiple aorta pulmonary collateral arteries (PA/VSD/MAPCA) has proven to be challenging. Therapeutic approaches have included staged unifocalization, shunting, coiling of collateral vessels, and heart/lung transplantation"

She already has a shunt, and they already coiled one of her collateral vessels. Dr. C talked about inserting stents later in her life (he's being optimistic about her chances for survival, at least..).

I have been up and down emotionally since Friday. I am doing fine, then someone asks me how the baby is...or when her surgery is, and I fall to pieces answering them. I cried 3 separate times at work yesterday and I'm tearing up as I write this. I really should at least TRY to be strong, but it scares the crud out of me that my daughter has to undergo this risky operation in 8 days. :(


  1. You told me to comment so here it is. I am reading the blog. You are the strongest person I know and you should not feel bad for crying once in a while.

  2. I'm sorry you and her have to go through this. It's SO much to ask. Life is SO unfair and so unpredictable. It's okay to be mad and certainly okay to cry! If you didn't love her so much it wouldn't hurt so much!She and you will be in our prayers.

  3. Melodie,

    Since it is so complex, have they suggested you take her else where? Have you thought about it?

  4. Its never a bad thing to cry.. Thats how we get thru somethings.. you are a very strong mama so stay taht way. I have faith and I will and have been praying for you guys.. and im sure many others are parying for u guys as are part of the most loveing heart familes ever <3