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.
Sometimes heart surgery in children is required for repairing defects in the heart which a child might have born with (known as congenital heart defects) and heart diseases which he gets after birth, which require surgery. Pediatric Cardiac Surgery deals with operative procedures in the newborn and unborn children and youngsters suffering from cardiac dysfunctions, structural, functional and rhythm-related issues of the heart also.
Pediatric Cardiology Facilities
The Paediatric cardiology department of any hospital offers all non-invasive diagnostic and paediatric cardiac interventional services. The diagnostic modalities are inclusive of foetal echocardiography, transthoracic and transesophageal echocardiography, round the clock Holter, CT and MR angiography as well as diagnostic cardiac catheterisation. Cardiologists, cardiovascular surgeons, anesthesiologists and other specialists work closely together to care for newborn as well as unborn children suffering from cardio-vascular disorders who provide exceptional pre and post operative services.
Pediatric Cardiothoracic Surgery
There are a number of Pediatric Cardiology Surgeries such as balloon atrial septostomy, Valvuloplasty/Angioplasty, Patent Ductus Arteriosus, Ventricular Septal Defect and Atrial Septal Defect, Tetralogy of Fallot, Total Anomalous Pulmonary Venous Return, Double Outlet Right Ventricle etc. The major ones are:
Balloon Atrial Septostomy (BAS) : This technique, also known as the Rashkind procedure used for enlarging a hole between the right atrium and the left atrium. It is often used to manage patients with transposition of the great arteries. Here the larger hole improves oxygenation of the blood.
Valvuloplasty/Angioplasty : Valvuloplasty is that process where a small balloon is inserted and inflated for stretching and opening a narrowed (stenosed) heart valve. On the other hand, angioplasty is a non-surgical process which can be used for opening blocked heart arteries.
Patent Ductus Arteriosus : This is a kind of defect in infants where vessel (the ductus arteriosus) fails to close soon after birth which results in abnormal blood flow, between the pulmonary artery and aorta, which takes the blood from the heart to the lungs and to the rest of the body. To treat it, an incision is made under the chest through which tubes are inserted to regulate the flow of blood supply.
Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD) : Both of these are congenital defects. In ASD, the wall that separates the upper heart chambers (atria) does not close completely. The surgery here involves a placement of an ASD device into the heart through catheters, which is inserted by making a tiny incision in the groin area. While in VSD, happens at the time of birth. It is explained as one or more holes in the wall that separates the right and left ventricle of the heart. In pre-natal stages, the right and left ventricles of a heart are not separate. As the fetus grows, a wall is formed for separating the two ventricles but if the wall does not form completely, a hole remains. This can be treated by inserting cardiac catheterization.
Tetralogy of Fallot (ToF) : Another congenital heart defect, it is a constellation of four abnormalities, which result in insufficient oxygen in the blood. In this case, a surgery is needed for restoring these defects which are caused, main; paid at the time when the infant is young.
Apart from the Above mentioned Pediatric Cardiac Surgeries , some of the others have been listed below
- BT Shunt / PA plasty on bypass/Surgical atrial septectomy
- ASD / PAPVR/ GLENN/ VSD/ TOF/ PAVC/ DORV
- All Re-do cases/ CAVC/ FONTAN
- Systematic-Pulmonary Artery SHUNTS
- All cases(3 months old/Arteial Switch Operation/Truncus Arteriosis)
- CoA/Simple Vascular Ring/Pacemaker Insertion
- Cases(3 months old/Shunts/PAB/Unifocalization/CoA/Complex Rings)
FAQs for Pediatric Cardiology
Pediatric Cardiology is a specialty, which addresses heart problems in babies including unborn babies, children, and teenagers. Pediatric heart surgeries are required to fix defects in a child’s heart, it is also known as congenital heart defects. Congenital heart disease (CHD) is one of the major reasons for the improper growth of heart or blood vessels before birth.
There are different types of pediatric surgeries such as Balloon Atrial Septostomy, Patent Ductus Arteriosus (PDA) repair, Balloon Pulmonary Valvuloplasty, Balloon Angioplasty, Tetralogy of Fallot Repair, Ventricular Septal Defect (VSD) repair, Atrial Septal Defect (ASD) repair, Total Anomalous Pulmonary Venous Return (TAPVR) correction, Double Outlet Right Ventricle (DORV) repair etc.
There is no particular reason for heart disease in children. Sometimes heart problems occur during pregnancy. As per the studies, heart diseases also occur due to environmental factors and genetics. Children can even get heart disease after the viral infection.
Children with heart disease may grow or develop more slowly than other children. Congenital heart disease affects thinking and motor development. The child may look younger, thinner, and frailer than other children of the same age. It may differ for each child and each heart condition. This can be discussed with your doctor for the prevention of the same.
After surgery, the child will be shifted to the PICU (Pediatric Intensive Care Unit). Children have to stay there for at least 2 to 3 days. It depends on the child’s medical condition.
The recovery process varies from child to child. After the surgery, the child shifts to the intensive care unit (ICU) and has to stay in the hospital for three to five days, depending on the type of surgery. Typically, it takes 6 weeks or more to recover at home after cardiac surgery. In the case of major surgeries, recovery may take 6 to 8 weeks.
After surgery, your child will have tubes and pacing wires for breathing and other medical conditions. If you wish to hold your child, then ask from the doctor or child nurse in PICU. They will show you a safe way to carry your baby.
These diseases can be diagnosed with a detailed examination and evaluation. After having detailed descriptions regarding family history, physical examination, and some tests like electrocardiogram (ECG or EKG). For a few children, cardiac magnetic resonance imaging (MRI) or computerized tomography (CT scanning) is required to diagnose the problem.
The complications after heart surgery includes renal problems, anemia, gastrointestinal issues, lung problems, infection, and vascular complications. However, there are many advanced treatment technologies available to reduce complications.
Most heart problems need open-heart surgery. But due to advanced technology in cardiac catheterization, some heart defects can be treatable without an operation such as Patent Ductus Arteriosus (PDA), Atrial Septal Defect (ASD) and Ventricular Septal Defects.
Children may behave differently after surgery. They may be clingy and irritable, which is due to the pain. They may do things, which they were not doing before their surgery. So it is important to support the child throughout. Mostly, after the surgery children live a healthy life. Their growth rate, activity levels, and appetite will be normal in a few weeks after surgery.
Yes, the child will have a scar in the middle of the chest and some small scars of drain tubes after open-heart surgery. These scars fade after a few months of surgery.
Yes, children with heart disease have special care needs. You should be very careful with this as they have special needs for medical care and other treatments. Always follow doctor’s recommendations regarding medicines, good hygiene, healthy diet, and activities.
The symptoms of heart disease in children are like breathing difficulty, too much sweating, improper growth, frequent chest infection, lips, toes and fingers get blue, and feeding difficulty.
There are many ways you can help your child in a hospital such as bringing their favorite toy or blanket to make them comfortable in the hospital and staying with your child. Also, encourage naps to promote healing.
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