Our meeting was today at 4 pm and the cardiac docs and fellows were pleased with small gains made over last 24 hrs. Vent settings were weaned, meds were decreased and Ajay was a bit more alert. He came off paralytic drugs and kept him sedated comfortably, in which he could move around but wasn't struggling or in pain. He was able to sign freely
They (we) decided that Ajays best chance at pulmonary blood flow was to put in a larger shunt on the right side of his lung, which was originally inserted last year. Increasing the shunt would give Ajay the ability to compensate for loss of his left lung function. The risks are high as any open heart surgery, but they feel the risks are slightly less because the ground work has already been laid. The flow from the conduit, shunt and collaterals are working well, and have been since last summer. The docs feel that since the right lung is already functioning, inserting a larger shunt isn't as traumatic as starting from scratch as they attempted on the left lung on Wed.
Open heart surgery is scheduled for Tuesday at 9am.
I will update everyone as Ajay enters recovery.