Transposed veins....

jay-tea

Has anyone dealt with this issue? My friend had her a/s this morning and is being sent back for another u/s and an ekg to take a look at the baby's heart for a possible transposition of veins in the heart.

She's looking for experience with this, understanding that the baby would need surgury shortly after birth and was wondering how long she should expect for a NICU stay.  All things her doctor could tell her... but it's a long weekend ahead.

TIA!

happyhoopla

NICU RN here.

I'm assuming you are asking about transposition of the great vessels. What has happened is that the pulmonary artery, which normally moves unoxygenated blood to the lungs and the aorta, which moves oxygenated blood to the body, have switched. So, blood that has already gone through the lungs ends up going back to the lungs and blood that doesn't have oxygen is sent back out to the body. In a fetus, there is a tiny duct (PDA...patent ductus arteriosis) that allows a good deal of blood to bypass the lungs and it normally closes at birth. For babies with transposition, this duct is kept open by a medication called Prostin. This allows some of the blood with oxygen to essentially take a detour and go out to the body. It is ESSENTIAL that this duct stays open. Babies with transposition are usually pretty stable and are allowed several days in the NICU for all of their systems to regulate prior to surgery. The first surgery involves a hole being made between the two atriums (lower chambers of the heart), which allows even more oxygenated blood to be picked up by the aorta and moved throughout the body. This surgery is usually done with a catheter that is inserted through a vein, so it's not very invasive. The second surgery is usually done around a month old is the one where the two vessels are actually switched back. These kids tend to do very well after surgery and have normal lives. Of course any surgery carries risks, but this one is relatively simple.

I hope this all made sense. Let me know if you have any other questions.

jay-tea

Thanks so much!  Do the babies usually stay in the hospital between the two surgeries or do they go home?

happyhoopla

I'm not sure. At my hospital after the first surgery they move over to the PICU, so we don't do any of the postsurgical care. I would imagine it depends on the specific baby. I think the first surgery enables enough oxygen mixing for a baby to be stable at home.