Two Weeks! Details on murmur

Today Loki is two weeks old. The current concern is regarding his heart murmur. A murmur is an irregular sound, and is just a symptom. The actual problem is a patent ductus arteriosus (PDA). In this, a baby's ductus arteriosus fails to close. The duct is a short connection between the pulmonary artery (which sends blood to the lungs) and the aorta (which sends blood with oxygen to the body). With the duct still open, blood that shouldn't mix mixes, resulting in inefficient circulation.

This is first treated with a drug, indomethacin. This constricts the arteries, hopefully choking supply to the duct, which eventually dies off. Loki had a PDA earlier, and responded to the drug, but the duct seems to have reopened. The medical staff is trying three courses of indomethacin. He presently on his second course. The drug treatment works in about three-quarters of cases. If he fails to respond to the drug, the duct will be closed surgically. Apparently, in the range of preemie surgery, this is a fairly routine procedure. It is done in his normal room and takes only 20 minutes. Still, it is heart surgery on a tiny dude.

A consequence of the surgery would be that it will probably set him back somewhat. Loki will be weaker as he recovers, and will need the respirator. So the breathing tube will not be removed unless the drug works.

He is getting another blood transfusion today. I am hoping that this will make the drug more effective.