Some good news!

Sorry this post is a little delayed.  I know many of you are wondering how our appointment at Mott Children's went.  It was an anxious week leading up to the appointment but we actually got some relatively good news.  It's been a huge relief.  

We had our followup fetal echocardiogram at the CS Mott Children's Hospital at the University of Michigan were we met an amazing team of people who work in pediatric cardiology.  While the test showed that Caroline does indeed have aortic stenosis (a narrowing of the valve that is located between the left ventricle and the aorta), the doctor's diagnosis was far more positive than that we received in Italy.  This narrowing has put increased stress on the left ventricle and caused some reverse blood flow, or regurgitation, from the left ventricle to the left atrium.  The doctor said that both of these conditions are to be expected given the stenosis.  Due to the fact that Caroline's stenosis is moderate to severe and that she does have partially reversed blood flow in her heart, her blood is flowing both right to left and left to right, our case is being reviewed by the head of the pediatric cardio unit to see if fetal intervention is necessary.  The doctor we saw was fairly certain that it would not be.  We have an appointment with a high risk OB as well as a follow up fetal echocardiogram in the coming weeks to confirm the diagnosis.  (They were not able to see all of the aortic arch this time round and are hoping get a better view next time.)  Of course anything can happen but the good news is that if everything goes according to plan, I should be able to carry Caroline to term and have a normal delivery without problem.  

Immediately after birth, the doctors will put Caroline on an IV medication to ensure that the duct between the aorta and pulmonary artery remains open (it usually closes after birth).  They will then perform tests to determine the best course of action.  The best case scenario in the short term would be to insert a catheter into her heart and inflate a balloon inside of the aorta in order to widen the opening in the artery.  If the blockage is more severe or if the aortic arch is affected, immediate surgery might be required.  Depending on how things progress, Caroline will likely need to have the aortic valve replaced but when is unclear.  It could be when she is an infant, a toddler, or a teen, it all depends.  While Caroline's condition is still serious, this is obviously a big improvement from what we were told in Rome.

The doctors here said that 8 out of a 1,000 babies are born with heart defects.  Of those heart defects, aortic stenosis is the most rare and occurs more often in boys than in girls, so little Caroline is a special case.  C.S. Mott Children's Hospital is recognized as one of the best in the United States for this sort of thing and the team of doctors there have presented us with workable treatment options.  We are incredibly lucky that Ryan's family lives only an hour away.  The current plan is for me to stay in the States until the baby is born and for a short time after.  I am being set up with a high risk OB, a genetic counselor, and a social worker, all who will follow our progress through the rest of the pregnancy.  

Thank you again for all of your thoughts and prayers!  We'll keep you updated as things develop.