Hello friends and family,
    Yesterday I went and talked with the heart doctor Roger Brightbart at Boston Children's Hospital. Ruth will be most likely having open heart surgery tomorrow, Friday June 29th, 2018. The surgery will take 5-8 hours. They have to close 3 shunts (holes) in her heart. She will be on a ventalator while in operating room. With the 3 holes in Ruth's heart the doctor told me that there is red and blue blood that is in the heart. With the holes she has the red and blue blood are mixing. We will be getting updates every 90 minutes. I also found out because of her conditions she has pulmonary hypertension. 

The three holes that are in Ruth's heart are called PDA, ASD, and VSD.

PDA- Patent Ductus Ateriosus
What is it?
Before a baby is born, the fetus's blood does not need to go to the lungs to get oxygenated. The ductus arteriosus is a hole that allows the blood to skip the circulation to the lungs. However, when the baby is born, the blood must receive oxygen in the lungs and this hole is supposed to close. If the ductus arteriosus is still open (or patent) the blood may skip this necessary step of circulation. The open hole is called the patent ductus arteriosus. 
What causes it?
The ductus arteriosus is a normal fetal artery connecting the main body artery (aorta) and the main lung artery (pulmonary artery). The ductus allows blood to detour away from the lungs before birth.
Every baby is born with a ductus arteriosus. After birth, the opening is no longer needed and it usually narrows and closes within the first few days.
Sometimes, the ductus doesn't close after birth. Failure of the ductus to close is common in premature infants but rare in full-term babies. In most children, the cause of PDA isn't known. Some children can have other heart defects along with the PDA.
How does it affect the heart?
Normally the heart's left side only pumps blood to the body, and the right side only pumps blood to the lungs. In a child with PDA, extra blood gets pumped from the body artery ( aorta) into the lung(pulmonary) arteries. If the PDA is large, the extra blood being pumped into the lung arteries makes the heart and lungs work harder and the lungs can become congested.



ASD- Atrial Septal Defect
What is it?
A "hole" in the wall that separates the top two chambers of the heart.
This defect allows oxygen-rich blood to leak into the oxygen-poor blood chambers in the heart. ASD is a defect in the septum between the heart's two upper chamber's (atria). The septum is a wall that separates the heart's left and right sides.
What causes it?
Every child is born with an opening between the upper heart chamber's. It's a normal fetal opening that allows blood to detour away from the lungs before birth. After birth, the opening is no longer needed and usually closes or becomes very small within several weeks or months.
Sometimes the opening is larger than normal and doesn't close after birth. In most children the cause isn't known. Some children can have other heart defect's along with ASD.
How does it affect the heart?
Normally, the left side of the heart only pumps blood to the body, and the right side of the heart only pumps blood to the lungs. In a child with ASD, blood can travel across the hole from the left upper heart chamber (left atrium) to the right upper chamber (right atrium) and out into the lung arteries.
If the ASD is large, the extra blood being pumped into the lungs work harder and the lung arteries can become gradually damaged. 

VSD- Ventricular Septal Defect
What is it?
VSD is a hole in the wall separating the two lower chamber's of the heart.
In normal development, the wall between the chamber's closes before the fetus is born, so that by birth, oxygen-rich blood is kept from mixing with the oxygen-poor blood. When the hole does not close, it may cause higher pressure in the heart or reduced oxygen to the body.
What causes it?
In most children, the cause isn't known. It's a very common type of heart defect. Some children can have other heart defects along with VSD.
How does it affect the heart?
Normally, the left side of the heart only pumps blood to the body, and the heart's right side only pumps blood to the lungs. In a child with VSD, blood can travel across the hole from the left pumping chamber (left ventricle) to the right pumping chamber (right ventricle) and out into the lung arteries. If the VSD is large, the extra blood being pumped into the lung arteries makes the heart and lungs work harder and the lungs can become congested. 

Pulmonary Hypertension- is high blood pressure in the arteries to the lungs.

red blood- oxygen-rich

blue blood- oxygen-poor