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She nodded. “It wasn’t picked up on during Mom’s ultrasound. She only had one, between four and five months, but the anomaly mustn’t have been as prominent as Mom says nothing unusual was mentioned.”
McKenzie moved the conducer over to where she could see the ductus arteriosus. The small vessel that connected the aorta to a pulmonary artery was still patent, allowing oxygenated blood to travel from the right ventricle to the aorta. Thank goodness.
If the opening closed, as it normally did within a couple of days, blood wouldn’t be able to be pumped to the body.
If blood wasn’t being pumped to her body, Sawyer would die.
“Is she on Prostaglandin E1?”
“Not yet,” McKenzie answered, knowing they needed to start the substance that the body naturally made to keep the vessel open while in utero, but that the body stopped making at birth. “She’d just started showing symptoms right before I was consulted and you’re seeing this as I am.”
“Gotcha. I’ll get an order for stat Prostaglandin E1 so we can keep that vessel open,” Ryder offered, walking over and logging into the bay’s computer to type in the order.
The nurse came back into Sawyer’s bay and Ryder told her what he’d ordered.
The nurse nodded, then went to carry out the order to start the medication that would, hopefully, prevent Sawyer’s ductus arteriosus from closing.
“It’s on its way,” he assured her, watching as McKenzie still checked the baby with the ultrasound machine.
“Look at the foramen ovale.” She pointed out the hole between Sawyer’s heart ventricles. “It’s patent, but what do you think?”
She let him take the ultrasound conducer so he could run it over the baby’s chest to get the views he wanted. He did so, studying what he saw.
“The opening is too small,” he yet again verbalized what she’d been thinking.
“She’ll need to go to surgery as soon as I can get her on schedule.”
“Yes,” Ryder agreed. “Her oxygen level is running low enough even with her oxygen mask that you’re going to need to put her on a ventilator as well to keep her from getting into trouble.”
McKenzie nodded. “Poor little sweetheart has a long road ahead of her.”
“Yes, she does, but a road that’s smoother than it used to be.”
Something in his voice had McKenzie lifting her gaze from the baby to stare at him.
He had an expression she’d never seen on him in the past, one that hinted his mind had gone somewhere far beyond the pediatric cardiac care unit where they were.
Was he thinking about the research he was involved with?
Ryder belonged to a research team involved in 3D printing of human cardiac tissue research that hoped to eventually be able to use the printed tissue for surgical rebuilding of too-small aortas and to repair other congenital heart anomalies, among other heart repairs.
Not long after they’d met he’d told her the research opportunities had been what led his move to Seattle, that the development of 3D-printed cardiac tissue opened the doorway to great advances and better outcomes of the care they provided their patients, and he’d wanted to be a part of that research.
Was he wishing they were further along so Sawyer could benefit from the research being done at Trevane Technologies?
Or had something else caused the odd look on his face?
“Do you want me to consult one of the other surgeons?”
Seeming to snap out of whatever had momentarily taken hold, he shook his head. “Why would you do that when I’m already familiar with her case?”
“I just thought...” She paused, not sure whether to remind him that prior to a few days before he’d gone out of his way not to share patients with her, that her patients were always assigned to one of his colleagues, but never him. “If you’re willing to take on her case, that would be wonderful.”
“I’m willing,” he assured her as he pulled out his phone and punched in a number. “Oddly enough, I’ve a Glenn shunt scheduled later this morning on a five-month-old.”
McKenzie’s brow lifted. Fortunately, they didn’t see many hypoplastic left heart syndrome cases, so to diagnose a new one, especially one not picked up on during ultrasound, and Ryder to be doing surgery on another on the same day was indeed a coincidence.
The Glenn shunt was the second phase of the series of surgeries Sawyer would need on her heart. Usually that procedure occurred four to five months after the Norwood, the procedure that would connect the superior vena cava, which brought blood back to the heart from the upper half of the body to the pulmonary arteries to the head and then the lungs to be reoxygenated.
