The major goal of the cath was to determine if Josiah is a candidate for his next open heart surgery, the Glenn, and to get a clearer idea of his overall heart and lung status. Josiah is unfortunately not a candidate for the Glenn. His lung pressure are way to high for him to tolerate the way they would re-plumb his heart with this surgery. He has what would be called pulmonary hypertension, which is not good. The high pressures in lungs make it more difficult for his heart to pump blood to them. Blood naturally wants to go to areas of lower pressure, so because his lungs are under high pressure his heart has to pump harder to push blood to them. This puts added stress on Josiah's heart and it was determined from the cath that Josiah's heart function has gotten worse due to this stress. The other very discouraging news was that when they measured the oxygen saturations of the blood in his pulmonary veins it was low. Blood leaves the lungs through the pulmonary veins. So that should be the point when the blood holds the most oxygen. Even in heart babies blood at that point should be well oxygenated, in the 90- 100% range. His saturations there were in the low 70's and this was while he was being given 100% oxygen from his ventilator. They attempted to turn his oxygen down to room air (21%) to see what his saturations would look like and they dropped into the 50's. What this means is that Josiah's lungs are not able to oxygenate his blood very well at all, making it pretty clear that Josiah may not be able to come off the ventilator for a very long time if ever.

We still have many questions to ask and hopefully answers to find about what our next steps are, though they are limited it seems. As of right now they have put him on some additional medications that will help to relieve some of the stress on his heart.

I'm not even going to get into Josiah's long term prognosis at this point because we have more talking to do with the doctors and I don't want to put things out there in blog world that are not true. So we will keep updating as we have further discussions with our doctors. Our surgeon is out of town right now and we have several questions for him, so it will be next week before we get a chance to speak with him.

Thank you for you prayers and support as always.

- a heart that holds on