We just got home from visiting Gaines. The doctors got the results from his heart echo today and I am going to try and explain everything. I am going to give the short version excluding all the medical terms.
From the heart echo the doctors confirmed that his PDA valve is still open, that the blood flow in the PDA is only flowing in one direction, and that the left side of his heart is enlarged. Originally the PDA valve had bilateral blood flow. The pulmonary hypertension in Gaines' lungs was causing enough pressure in his lungs that blood was flowing through the PDA valve in both directions; from the heart to the lungs and from the lungs to the heart. This bilateral flow was actually helping Gaines' pulmonary hypertension. Now, the pulmonary hypertension is gone which means the pressure in his lungs has decreased. This means the flow in his PDA is now mostly from his heart to his lungs.
The flow of blood from his heart to his lungs basically means the blood is getting back to his heart much quicker. This causes the left side of his heart to work harder which is why it is enlarged. This flow of blood through the PDA also means less blood is going to the rest of his body and some of his other organs may not be getting adequate blood supply.
In a separate issue (but related), Gaines has not been digesting his food very well. This could be because his intestines are not getting adequate blood flow and not functioning properly. Again, it all goes back to the PDA valve.
So, the doctors think it is time to close the valve. They close the valve by giving Gaines medicine once per day over the next three days. The first dose will be given at 10 PM tonight. On Thursday, Gaines will have another heart echo to make sure the PDA valve is closed. We were told this treatment to close the PDA valve works 50-60% of the time. If it does not work, the doctors will consider the risks/benefits of leaving the PDA valve open versus closing it with a surgical procedure. Hopefully, the PDA valve closes.
There is another concern if the PDA valve closes. Gaines has 4 small holes in his heart that the doctors currently classify as insignificant. If the valve closes, the amount of blood going through the heart and the pressure in the heart will increase and possibly cause these 4 small holes to become significant. The 4 small holes could basically do the same thing the PDA valve was doing, which is allowing blood to flow in the wrong direction back to the lungs. If this happens, there is a way to treat this with medication and surgery if it requires it.
Long story short, we need to close the PDA valve. We hope we can close it without a surgical procedure. If it closes, we hope Gaines' little heart tolerates it. I know this was a lot of information and very specific, but I wanted everyone to know exactly what prayers need to be said for Gaines. He has proven to be a fighter and we expect no different from him now.