The following is a message from Patty regarding Morgan - goodness, the Fox family has had some hospital time and now it looks like more in the future.
Dear Friends and Family,
Links below can help explain some information regarding the condition that Morgan has been diagnosed with. In short, his MRI results indicate he has "anomalous pulmonary venous drainage of the right middle lobe pulmonary vein into the distal right SVC." Also, it is suspected that he has another condition that often accompanies this, which is "sinus venosum ASD." These are both congenital birth defects which usually do not present until mid-thirties, so we are lucky that it was detected now, before irreversible damage was done. As far as I understand, they both contribute to some blood returning to the right ventricle from the lungs, when it should instead go to the left ventricle. This causes the right ventricle to work harder and enlarge as a result, which can lead to other problems.
At this time, the cardiologist has referred us to a specialist at the Texas Heart Institute, whom Morgan will see July 10. The two doctors concurred after reading Morgan's MRI that he did not need immediate treatment and this should not keep him from starting at Duke. I suspect that at the July 10 appointment, the specialist will want to run more test to confirm the sinus venosum. If he does have that condition, based on what I have read, he will probably need surgery within a couple of years to prevent damage. Since I am not actually a cardiologist, we will be better off waiting to hear what he says! The MRI and echocardiogram tests show that otherwise, his heart is functioning well and normally in other regards.
Anyway, I know many of you have been waiting to hear more about what was going on. Thanks for being so supportive. Here are some excerpts from the links below.
Partial anomalous pulmonary venous connection (PAPVC) with intact atrial septum is a rare congenital cardiac defect. As the name suggests, in PAPVC, a few of the pulmonary veins return to the right atrium instead of the left atrium. Thus, some of the pulmonary venous flow enters the systemic venous circulation.
Anatomically, PAPVC can involve a wide variety of connections, and PAPVC from the right lung is twice as common as PAPVC from the left lung. The most common form of PAPVC is one in which a right upper pulmonary vein connects to the right atrium or the superior vena cava (SVC). This form is almost always associated with a sinus venosus type of atrial septal defect (ASD).
Children with partial anomalous pulmonary venous connection (PAPVC) usually remain asymptomatic and are referred based on an incidentally noted cardiac murmur. Symptoms may occur in older patients and may be secondary to right-sided volume overload or pulmonary vascular obstructive disease.
In simple terms, (yeah, right, says Patty) an atrial septal defect (ASD) is a deficiency of the atrial septum. ASDs account for about 10-15% of all congenital cardiac anomalies and are the most common congenital cardiac lesion presenting in adults. Sinus venosus ASDs account for only 10% of ASDs. The remaining ASDs are ostium secundum type (70%), ostium primum type (20%), and unroofed coronary sinus (coronary sinus septal defects) (<1%). Most children with sinus venosus ASD are asymptomatic, but may develop symptoms as they age. Excellent surgical results with a mortality rate near 0% can be expected. This is particularly true in patients who undergo repair when younger than 15 years.
The more common sinus venosus type defect (often referred to as the "usual type") occurs in the upper atrial septum and is contiguous with the superior vena cava (SVC). The lesion is rostral and posterior to the fossa ovalis (where secundum type defects occur) and is separate from it. It is almost always associated with anomalous pulmonary venous drainage of the right upper pulmonary vein into the SVC. Less commonly, the defect may occur at the junction of the right atrium and inferior vena cava (IVC) and be associated with anomalous connection of the right lower pulmonary vein to the IVC. Rarely, sinus venosus defects occur posterior to the fossa ovalis without bordering the SVC or IVC. The predominant hemodynamic consequence is a left-to-right shunt through the defect.
Links:
http://www.emedicine.com/ped/topic2522.htm
http://www.emedicine.com/PED/topic2107.htm
Patty
Dear Friends and Family,
Links below can help explain some information regarding the condition that Morgan has been diagnosed with. In short, his MRI results indicate he has "anomalous pulmonary venous drainage of the right middle lobe pulmonary vein into the distal right SVC." Also, it is suspected that he has another condition that often accompanies this, which is "sinus venosum ASD." These are both congenital birth defects which usually do not present until mid-thirties, so we are lucky that it was detected now, before irreversible damage was done. As far as I understand, they both contribute to some blood returning to the right ventricle from the lungs, when it should instead go to the left ventricle. This causes the right ventricle to work harder and enlarge as a result, which can lead to other problems.
At this time, the cardiologist has referred us to a specialist at the Texas Heart Institute, whom Morgan will see July 10. The two doctors concurred after reading Morgan's MRI that he did not need immediate treatment and this should not keep him from starting at Duke. I suspect that at the July 10 appointment, the specialist will want to run more test to confirm the sinus venosum. If he does have that condition, based on what I have read, he will probably need surgery within a couple of years to prevent damage. Since I am not actually a cardiologist, we will be better off waiting to hear what he says! The MRI and echocardiogram tests show that otherwise, his heart is functioning well and normally in other regards.
Anyway, I know many of you have been waiting to hear more about what was going on. Thanks for being so supportive. Here are some excerpts from the links below.
Partial anomalous pulmonary venous connection (PAPVC) with intact atrial septum is a rare congenital cardiac defect. As the name suggests, in PAPVC, a few of the pulmonary veins return to the right atrium instead of the left atrium. Thus, some of the pulmonary venous flow enters the systemic venous circulation.
Anatomically, PAPVC can involve a wide variety of connections, and PAPVC from the right lung is twice as common as PAPVC from the left lung. The most common form of PAPVC is one in which a right upper pulmonary vein connects to the right atrium or the superior vena cava (SVC). This form is almost always associated with a sinus venosus type of atrial septal defect (ASD).
Children with partial anomalous pulmonary venous connection (PAPVC) usually remain asymptomatic and are referred based on an incidentally noted cardiac murmur. Symptoms may occur in older patients and may be secondary to right-sided volume overload or pulmonary vascular obstructive disease.
In simple terms, (yeah, right, says Patty) an atrial septal defect (ASD) is a deficiency of the atrial septum. ASDs account for about 10-15% of all congenital cardiac anomalies and are the most common congenital cardiac lesion presenting in adults. Sinus venosus ASDs account for only 10% of ASDs. The remaining ASDs are ostium secundum type (70%), ostium primum type (20%), and unroofed coronary sinus (coronary sinus septal defects) (<1%). Most children with sinus venosus ASD are asymptomatic, but may develop symptoms as they age. Excellent surgical results with a mortality rate near 0% can be expected. This is particularly true in patients who undergo repair when younger than 15 years.
The more common sinus venosus type defect (often referred to as the "usual type") occurs in the upper atrial septum and is contiguous with the superior vena cava (SVC). The lesion is rostral and posterior to the fossa ovalis (where secundum type defects occur) and is separate from it. It is almost always associated with anomalous pulmonary venous drainage of the right upper pulmonary vein into the SVC. Less commonly, the defect may occur at the junction of the right atrium and inferior vena cava (IVC) and be associated with anomalous connection of the right lower pulmonary vein to the IVC. Rarely, sinus venosus defects occur posterior to the fossa ovalis without bordering the SVC or IVC. The predominant hemodynamic consequence is a left-to-right shunt through the defect.
Links:
Patty
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posted by Great Eats at 6:58 AM
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