Date 

 Medical History

 06.12.05

Amelia Lee was born at Royal Free Hospital, North London at 17.13 and she weight 3.6 kilograms (7lb 15ozs).

 07.12.05

Had full check up at the baby clinic at the same hospital and was discharged on the same day.

 23.01.06

Amelia had her 6 week old check at Highgate Group Practice, her doctor noted that she has a loud systolic murmur and appears asymptomatic. She was being referred to a local hospital at North London – The Whittington Hospital.

 24.01.06

Pediatrics at The Whittington Hospital confirmed Amelia was born with a heart defect called Tetralogy of Fallot and referred her to Great Ormond Street Hospital for children in Central London.

 27.01.06

Amelia’s first outpatient appointment at Great Ormond Street Hospital (GOSH). Cardiologists confirmed her heart condition required corrective heart surgery. Her saturation was 100%.

 20.03.06

Follow up appointment at GOSH. To this date she has had no blue spells and gaining weight. Her saturation was 98%.

 31.03.06

Department of Cardiology at GOSH suggested Amelia should have her heart surgery within the next three months.

 12.04.06

She was placed on cardiac surgery waiting list.

 05.05.06

Pre-operative appointment at GOSH to complete all the pre-admission investigations prior to the surgery date.

 23.05.06 (Tuesday)

Amelia had had her open heart surgery at GOSH. The surgery took about 8 hours and was discharged on 03.06.2006.

 17.07.06

Amelia’s first post surgery checks up back at GOSH (after 6 weeks) and Her recovery was clinically well. She weight 7.14 kilograms and height 66.20cm.

There is mildly increased velocity through the right ventricular outflow tract and no further tests performed as Amelia is growing well with a good exercise tolerance.

 06.11.06

Follow up appointment at GOSH. Amelia has made good progress clinically. However, there is non-negligible degree of residual right ventricle outflow tract obstruction and the echo diagram in the clinic today was technically difficult and yielded results that were difficult to interpret because Amelia was extremely upset.

 12.02.07

Follow up appointment at GOSH on right ventricular outflow obstruction. The scan result showed a right ventricular hypertension with velocity just under 4m/sec.

Proposed to perform cardiac catheter within the next 6-8 weeks.

 05.03.07

GOSH reported that the obstruction developing underneath the aortic valve was related to the valve itself, but it looks as if there are muscle bundles underneath the valve which make balloon dilation procedure unhelpful.

 14.05.07

GOSH assessed Amelia’s heart development and she is very well. Her echo shows a gradient of 3.9 through the right ventricular outflow tract. It has changed since February 2007.

 10.09.07

Amelia’s weight was 11.1 kilograms and her height 80.9cm.

GOSH noted the right ventricular outflow obstruction was due to muscle bundles underneath the valve rather than obstruction at the valve itself. It is likely that Amelia will require further surgery to alleviate her right ventricular outflow obstruction. (Velocity of 3.5m/sec).

Suggested further outpatient review in 6 months’ time and recommend measures to prevent endocarditis.

 14.01.08

GOSH suggested to perform a cardiac catheter and angiogram to get information about the level of obstructions and the patency of the artery to the left lung and also to see if the narrowing in the blood flow can be stretched out with a balloon catheter.

 12.02.08

Pre-Operative Appointment for cardiac catheterization at GOSH.

 27.02.08

Amelia was admitted to GOSH for cardiac catheterization procedure.

 10.03.08

Follow up appointment at GOSH

 22.09.08

Amelia’s peak velocity on the right ventricular outflow tract was 3.8m/sec. The Consultant suggested to put her case for further discussion with the GOSH surgical team meeting.

 23.03.09

Follow up Appointment and GOSH proposed to discuss Amelia’s heart condition in Cardiac Planning Meeting.

 09.04.09

GOSH placed Amelia next surgery on waiting list and parents requested the routine surgery is scheduled after mid June 2009.

 04.06.09

Amelia's 2nd open heart surgery is on 26 June 2009 and pre-admission check is scheduled on 11 June 2009.

 Pre-surgery checked up at GOSH - ECG, X-ray, Blood sample taking, saturation, blood pressure etc.

 26.06.09 (Friday)

Amelia's surgery was scheduled at 11am and it took about 4.5 hours. After the surgery, she was taken to Intensive Care Unit at Cardiac Wing at Great Ormond Street Hospital. 

She was breathing by her own, without the support of the machine except for oxygen mask and half concious. She was asking for mummy and daddy.

Amelia's heart recovery was progressing very well and after ECG and Ecodiagram scan showed promising results, Amelia was allowed to go home. The Cardiologist advised Amelia to stay home and no outdoor activities for at least a week. Her heart rate was between 145-150.

Amelia was taken to A&E department at a local hospital for chest infection. She was admitted to the hospital for 48 hours antibiotics and close monitoring.

 Amelia was discharged from the hospital.

 Amelia's heart rate back to normal to 110 and below.

 Amelia was very happy to see all her friends in Moreton Day Nursery.

Routine check up at GOSH outpatient clinic. Amelia was looking well from the cardiac viewpoint. The doctor has arranged for Amelia to have a 24-hour ECG tape to assess whether the episodes of bigemini are reduced during her activities.

 GOSH invited Amelia to join the Tetralogy of Fallot research program.

Routine Check up at GOSH outpatient clinic. Amelia was doing well and they proposed to review her condition to once every 12 months and she may require another surgery to fix her valve when she is in her teenage age.

 Routine Check up at GOSH outpatient clinic. Amelia's heart development was excellent and they will review her development in August 2012.