The Rastelli repair

Update: Albie didn’t get his Rastelli the next week as was planned when this was written. We went home again to make him bigger and he ended up having his operation on 14 August 2012. But its still a good description of the operation itself, so I have left it here.

We’ve been rabbiting on about his ‘Rastelli’ and done nothing to explain exactly what will happen next week. For those of you who have wanted to know, here we go.

The Rastelli is open-heart surgery. That means that the operation will require Albie to be placed on a heart-lung bypass machine.   The bypass machine takes over the function of the heart and lungs to provide oxygenated blood to the body. Albie will also be cooled right down so he is hypothermic (body temperature is usually kept at 28ºC to 32ºC) throughout the repair. This slows the body’s metabolic rate, decreasing its demand for oxygen. Once he is on bypass, his heart will then be stopped so that it can be opened and repaired in a bloodless, still environment.

They will cut through his breast bone (sternum) to access his heart. At the end of the operation, the two edges of the breast bone are put back together with steel wires. After the chest is opened, to get access to the heart, the pericardial sac has to be opened too. This is the leather-like protective pouch the heart sits in. Who knew?

In the Rastelli repair, the heart will be fixed so that blood will be channelled through the ventricular septal defect that he has from the left ventricle to the aorta. A patch will be put in the right ventricle to prevent blood passing from the right ventricle to the aorta. A conduit (which is an artificial tube containing a graft valve from a human, cow or pig) will be sewn in to connect the right ventricle to the pulmonary artery.

Then the BT shunt he had installed in April will be taken out and all will be well with our wee boy. The operation will take up to 8 hours. I already know it will be the longest 8 hours of my life.

So that’s the low down on next week. There are of course a great string of complications that could happen, but just describing to you all what will happen is enough. We are scared, of course. But thankful too that we live in a country that can do this. The repair has to happen and the only thing to do is just trust.