I am so happy that I finally have a piece of good news to share about Annie tonight! Yesterday, Annie went to the cath lab so the doctors could attempt placing a stent in her superior vena cava, the main vein that flows into the heart. The doctors believed it was clotted and, if so, could be a major factor in the excessive drainage from her chest tubes. Before attempting this procedure, they expressed concern that the SVC might be entirely clotted off. If this were the case, they would not be able to thread a wire through it and there would be nothing they could do to try and help her. She had been scheduled to go today (Friday), but at the last minute, they found room to take her yesterday. They placed a catheter and injected dye into her venous system to see if there was any flow through the SVC and into the heart. They were disappointed that the dye did not show any flow through the SVC, but when they attempted to thread the wire through, they somehow succeeded. They also threaded the wire through the left innominate vein (a major branch of the SVC that was also clotted) and were then able to pull a balloon through and restore blood flow to both of these veins. They then placed a stent in her SVC, but as soon as they were finished, she began to clot above and around the stent in both veins. They ballooned them open again, and she began to clot again. At that point they decided to start tPA, the clot buster drug that we tried last week. This time, the catheter used for placing the stent could be used to administer the drug right at the site and the hope was, that because these clots were new, the tPA would be successful in dissolving them. Tonight, after running tPA for 24 hours, Annie went back to the cath lab so they could again inject dye and see if the clots were progressing or resolving. If they were found to be progressing, the doctors told me that nothing more could be done (I have heard this before, but know that we really are reaching the end of medical options for Annie).
After being with Annie for a short time, the doctors let us know that the tPA was working; the clots were much smaller and the flow through these two veins was really good! Such good news after two weeks of nothing but bad news! Amazing, how a little hope from the medical team can lift our spirits. The plan is to continue to run the tPA through the weekend in an effort to completely resolve the clots and then hope that she won't form clots again when the tPA is ended. Even if this works, Annie has a huge mountain to climb in order to get better and come home. In the eyes of the doctors, it is still a long shot, if not impossible. We understand that, but Annie has surprised them before and just might be capable of doing it again. Dr. Kaza stopped by her room on Wednesday and told me that while they are certainly going to "extraordinary" measures for Annie, he personally had not lost all hope for her. This was the first time we had heard any doctor express any hope in almost two weeks. We are praying that Annie gives the rest of them reason to change their minds!