Cardiac surgery in children is needed to repair the faults in the heart when the child is born with or has acquired after birth. It is done for child’s welfare and overall development physically. For a successful pediatric cardiac surgery, talented medical panel comprising doctors, nurses and other health care supporting staffs are required, who are skillful and have vast experience in this branch.
They can swiftly recognize the problems and the subsequent side effects and also how to respond swiftly if trouble arises. The pediatric surgery program helps out patients and their families with both emotional and psychological support before and after the surgery. We provide complete solution and make this task trouble free for the patient and relatives.
Some of the major Cardiac defects in Children:
It is seen that there is mixing of the pure and the impure blood or less supply to the parts of the body when there is defect/abnormality in the septum or the valves or location of the arteries. If the defect is complex and interferes with the existence of the child it requires immediate surgical intervention. The body of the child will turn blue if there is more amount of circulation of impure blood.
Atrial Septal Defect: (ASD)
It is often referred as a hole in the heart and is distinct opening present between the dividing walls of the atrium. ASD’s are common congenital defects in children and they are treated with few or no complications. In ASD, due to the opening present between the atrium or atria, some oxygenated blood from the left atrium passes through the hole into the right atrium were it gets mixed with the oxygen deficient blood and thus increases the total amount of blood that flows into the lungs.
Because of the huge flow of blood into the lungs, there is hissing sound which is also called as ‘murmur’ of the heart. A well experienced cardiologist can detect this sound and easily diagnose the defect. The hole can be located in several places on the atrial septum and varies from sizes. The symptoms and the management will depend on these criteria and ASD is more common among girls than boys and the exact reason is unknown.
Based on the size of the ASD and its location in the heart the symptoms are determined. Many children’s do not show any signs and develop normally. A child who has larger and complex ASD, show the following signs:
- Poor appetite
- Abnormal or poor growth
- Breathing problems
- Problem in lung and subsequent infection (Pneumonia)
- The lips and tongue will become blue color (Cyanosis)
The treatment is opted based on the child’s age, size, position and complexity of the defect. The small hole or defect will close unexpectedly without any treatment as the child matures.
Cardiac catheterization is a procedure were a thin, bendable tube is introduced into the blood vessel in the leg which then guides to the heart. The consultant measures the flow of blood, pressure and oxygen level in the chamber of the heart. An exclusive implant is sited into the hole in the septum and it will compress on the septum which then closes the hole enduringly. It is a time saving method with one night stay at the hospital.
During surgical intervention, the child will undergo open heart surgery. The surgeon opens the chest and the heart-lung device is attached to keep the heart working meanwhile the surgeon repairs/closes the hole. The hole is closed with the stitches by covering it with the surgical material. The tissues near the heart get healed after six months post surgery and hole will be covered completely.
When a child has ASD, it is a scary problem to their parents. But due to advanced technology and well experienced doctor’s the problem can be well managed. The child with corrected ASD can lead a healthy life with normal expectancy.
Ventricular Septal Defect: (VSD)
When a hole is found between the right and the left ventricle, it is called as ‘Ventricular Septal Defect’. Due to this some amount of blood in the left ventricle moves to the right ventricle through the opening. The oxygen affluent blood blends up with the oxygen poor blood and streams to the lungs through the pulmonary artery. It produces a distinctive sound called ‘heart murmur’ which is detected by the pediatric cardiologist.
There are different forms of VSD depending on the location in the ventricular septum. Among 40% of children born with the VSD does not need any treatment as it closes on its own if the hole is very small. But if the opening is large it requires surgical intervention.
- Breathing difficulties
- Tiredness or feeling weak
- Poor appetite
- Poor weight gain
Intra Cardiac Technique:
The ribs are cut open and connected to the cardiac-lung machine to maintain the circulatory and respiratory function. The surgeon then sutures the hole directly or covers it up with a patch. It is done under general anesthesia.
This surgical procedure is aided by catheter which is inserted into the femoral artery in the groin area. The catheter is slowly directed near the hole and corrected. The enlarged heart resumes back to its normal size soon and the pressure of the artery decreases.
When there is a mixture of four birth defects which influence the structure of the heart and the blood flow is called as ‘Tetralogy of Fallot’. About 10% of the newborn found to have this kind of disorder.
- Ventricular Septal Defect:
It is a condition where there is an opening in the septum or the wall; it disconnects the right ventricle from the left ventricle and prevents the mixing of the blood. Due to this, oxygen rich blood from the left ventricle merges with the right ventricle.
- Pulmonary Stenosis:
It is circumstances were the pulmonary artery that bonds the right ventricle becomes tapered. The main work of the pulmonary artery is to bring the oxygen poor blood from the heart to the lungs and it receives the oxygen rich blood and takes them back to the heart. When it is tapered, the heart works to pump out the blood to the lungs and only fewer amounts reaches out there.
- Right Ventricular Hypertrophy:
The muscular wall present in the right ventricle becomes thick and rigid.
- An Overriding Aorta:
The artery is present above both the ventricles which they get normally seated in the left ventricle in good working heart. Because of this, low oxygen blood is taken to the aorta and then to all parts of the body which is harmful and the pulmonary artery picks it up and pours into the lungs to collect the oxygen.
- Episodes of seizures and giddiness
- High chances of endocarditis
- Abnormal heart beat called as ‘Arrhythmia’
These defects are corrected by the following techniques,
Blalock’s Taussig Operation:
It is a soothing procedure which is performed in small babies to make high flow of blood to the lungs and tolerate the child to mature enough to bear the surgical treatment. The pulmonary artery and the subclavian artery are linked so that supply of oxygen rich blood is increased. This relieves the cyanosis to greater extent.
Total Corrective Surgery:
When the child attains two years or more, this method is performed. With a patch the VSD is clogged and the pulmonary valve which is rigid is opened. The success rate is high and most of the child led a well healthy life with limited restrictions.