Pediatric Cardiac Surgery in India
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Pediatric Cardiac Surgery at World’s Best Hospital in India
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Pediatric Cardiac Surgery often deals with heart problems in children, the cause of congenital heart diseases which are common heart ailments among new born children and involves deficiencies like structural defects, congenital arrythmias and cardiomyopathies, which result in different kinds of abnormalities related to the heart. Congenital heart disease is a cause of improper growth of the heart or blood vessels before birth.
Major Types of Cardiac Defects in Children :
ASD- Atrial Septal Defect ASD An atrial septal defect (ASD) — sometimes referred to as a hole in the heart — is a type of congenital heart defect in which there is an abnormal opening in the dividing wall between the upper filling chambers of the heart (the atria). In most cases ASDs are diagnosed and treated successfully with few or no complications. When an atrial septal defect is present, blood flows through the hole primarily from the left atrium to the right atrium.
This shunting increases the blood volume in the right atrium which means more blood flows through the lungs than would normally. If left untreated, atrial septal defect may cause problems in adulthood. These problems may include pulmonary hypertension (which is high blood pressure in the lungs), congestive heart failure(weakening of the heart muscle), atrial arrhythmias (which are abnormal rhythms or beating of the heart) and an increased risk of stroke.
Ventricular Septal Defect VSD have a hole in the wall of their heart between their right ventricle and left ventricle (the two lower chambers, where the blood leaves the heart). Normally, blood cannot pass between the ventricles. But when there is a hole between the sides of the heart, some oxygen-rich blood leaks from the left ventricle into the right ventricle and goes back to the lungs. The hole may be small and cause no symptoms, or it may be large and cause serious problems with blood flow. If the hole is large, too much blood will be pumped to the lungs, leading to congestive heart failure. Also, the heart will have to work harder to pump blood to the body. As a result of the extra work, the heart can get bigger.
Fallot’s Tetralogy Fallot was a doctor who spotted this particular type of heart defect. Tetralogy means fourfold – there are four defects found together. These four problems are:
- PULMONARY STENOSIS – Pulmonary means ‘of the lungs’. Stenosis means narrowing. Pulmonary stenosis is a narrowing at or below the pulmonary valve.
- VENTRICULAR SEPTAL DEFECT – Ventricular means ‘of the ventricles’ – the wall between the right and left sides of the heart .
- OVER-RIDING AORTA – -The entrance to the aorta, which should only take red (oxygenated) blood around the body, lies over the VSD, allowing the right ventricle to pump some blue blood directly into it.
- RIGHT VENTRICULAR HYPERTROPHY – The right ventricle becomes thickened as it forces blood into the narrowed pulmonary artery.
Double valve repair and replacement
Valves are openings between two chambers and also between a chamber and artery which allows unidirectional flow of blood. The patency of these valves is very important for normal flow of blood. The function of mitral valve (between left atrium and left ventricle) and the aortic valve (between left ventricle and aorta) is very important.
If these valves get narrowed, the amount of blood passing from left atrium to left ventricle (mitral valve) or from left ventricle to aorta (aortic valve) is drastically reduced. In this case the heart will pump blood harder to push it through the narrowed valves. But the blood will tend to go upwards back into the pulmonary vein and finally to the lungs.
Why is the Procedure required?
If the following warning signs are found in children, it indicates that a surgery is required:
- Blue or gray skin, nail beds and lips. These symptoms indicate that there is not enough oxygen in the blood (hypoxia).
- If the child has difficulty in breathing because the lungs are “wet,” congested, or filled with fluid (heart failure).
- If there exists problems in heart rhythm (arrhythmias) or heart rate.
- AIf there is lack of growth and development of a child. And the child is not able to sleep and eat properly.
How is the surgery performed ?
Following are the different techniques used for fixing congenital defects of the heart in children:
- Open heart surgery It is done under general anesthesia. Firstly an incision is made through the breastbone. Then some tubes are used to re-route the blood through a special pump called a heart-lung bypass machine. This machine keeps the blood warm and adds oxygen to the blood and it keeps on moving through the rest of the body while the surgeon is repairing the heart. Once the procedure is done, the machine is removed, and the heart is started and the breastbone and the skin incisions are closed.
- Thoracotomy This Procedure is used for some type of heart defect repairs, wherein the incision is made on the side of the chest, between the ribs. It is also called a closed-heart surgery. This surgery is done with the help of special instruments and a camera.
- In one kind of procedure a few small tubes are inserted into an artery in the leg and pass them up to the heart. Only some heart defects can be repaired in this fashion.