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>> WHAT WE WANT TO DO AFTER A BABY IS BORN IS WE WANT
TO STABILIZE THE CHILD, MAKE SURE THAT THERE ARE NO OTHER
ORGANS INVOLVED, BECAUSE THERE ARE OTHER ASSOCIATED
ANOMALIES IN SOME CHILDREN.
WE WANT TO MAKE SURE THAT THERE ARE NO GENETIC ISSUES
THAT WE NEED TO ADDRESS.
WE WANT TO MAKE SURE ALL THE OTHER ORGAN SYSTEMS ARE AS
GOOD AS THEY CAN BE AND ASSESS THEM IF WE HAVE TO.
AND THEN ONCE THAT IS DONE, THEN IT'S MORE A MATTER
OF SCHEDULING THE SURGERY.
>> WE HAVE IDENTIFIED SOME RISK FACTORS IN PATIENTS WHO
HAVE SINGLE VENTRICLE TYPE OF HEART DISEASE.
>> CERTAIN FORMS OF SINGLE VENTRICLE MAY NOT DO AS WELL
AS OTHERS.
>> SINCE ONE HAS TO UTILIZE THE WELL-FUNCTIONING
VENTRICLE TO DO THE JOB OF DELIVERING BLOOD FLOW
TO THE BODY, IF THAT SINGLE VENTRICLE IN SOME WAY IS NOT
FUNCTIONING WELL, OR IF THERE'S LEAKAGE OF THE VALVE
THAT LEADS INTO IT, THAT COULD BE A SIGNIFICANT RISK
FACTOR FOR RECONSTRUCTION.
>> MANY TIMES THERE ARE OTHER ASSOCIATED GENETIC
ABNORMALITIES THAT WE HAVE TO LOOK FOR CAREFULLY,
AND THESE SORTS OF GENETIC ABNORMALITIES WOULD PROVIDE
INCREMENTAL OR INCREASED RISK FOR THE OPERATION ITSELF.
>> IF THE BABIES ARE IMMATURE,
PREMATURE, THAT CAN ADD SIGNIFICANT RISK.
>> ONE OF THE THINGS THAT CAN CAUSE A REAL PROBLEM
IS WHEN THERE'S BLOCKAGE TO BLOOD FLOW FROM THE LUNGS
GETTING BACK TO THE HEART.
>> AN OBSTRUCTION OF BLOOD FLOW COMING OUT OF THE LUNG,
THAT WE KNOW CAN RESULT IN POOR DEVELOPMENT
OF THE LUNGS AND CAN ADD RISK, AS WELL.
>> FOR MANY CHILDREN WITH COMPLEX HEART DISEASE,
THERE'S BLOCKAGE OF THE BLOOD EITHER GOING
TO THE BODY OR TO THE LUNGS.
AND THERE'S A BLOOD VESSEL CALLED THE DUCTUS ARTERIOSUS
WHICH CONNECTS THOSE TWO ARTERIES.
EVERYBODY HAS ONE, AND IT USUALLY CLOSES AFTER BIRTH.
>> YOU CAN KEEP THAT BLOOD VESSEL OPEN
WITH A MEDICATION CALLED PROSTAGLANDINS.
AND SO, THEREFORE, BY GIVING A BABY PROSTAGLANDINS,
YOU'RE ACTUALLY REPLICATING THE SAME PHYSIOLOGY THAT IT
HAD IN THE UTERUS, WHEN IT WAS VERY STABLE,
TO WHEN IT'S OUTSIDE THE UTERUS.
>> SO INSTEAD OF HAVING A CHILD COME IN CRITICALLY ILL
WHERE THERE WAS NOTHING WE COULD DO,
WE CAN STABILIZE THESE CHILDREN,
DO DIAGNOSTIC PROCEDURES, AND THEN HAVE A STABLE CHILD
WHO GOES FOR SURGERY.