The heart (or cardiac system) is the most important primary pump in your child’s body. It has the biggest job of pumping and circulating oxygenated blood to his or her body and deoxygenated blood to the lungs for removal from the body. In children, the heart can be affected by developmental anomalies at birth (congenital heart defects) or by acquired causes such as cardiac tumors, after birth.
What is pediatric heart surgery ?
Pediatric Heart Surgery refers to heart surgery in children who are born with congenital heart defects and diseases of heart which a child acquires after birth. The defect may range from a small hole in the child’s heart to a more severe condition. Occasionally these defects are identified before birth and in some cases after the child is born. These heart defects may be asymptomatic or symptomatic. The ones which are symptomatic are often treated at an early age where as the ones which do not display any symptoms progress until adulthood.
How is pediatric heart surgery different from adult heart surgery ?
Whenever a child is ill, it adversely affects the entire family. Pediatric heart surgery is done by pediatric cardiac surgeons who specialize in giving treatment to children with congenital heart defects and other cardiac conditions. There will be a whole pediatric heart surgery team to do the heart procedures, ranging from the
most basic to highly complex procedures. Your child’s heart team will consist of many specialists, such as pediatric heart surgeons, cardiologists and anesthesiologists. The specialized pediatric cardiac anesthesiologist is there to administer anesthesia, sedation and pain management for children, as the requirements of anesthesia definitely vary from child to adult. As the patients in this surgery are children, establishing an accurate diagnosis, making a customized treatment plan for the most minimally invasive surgery, and protecting other organs such as the brain are essential for a good surgery. During pediatric heart surgery, advanced measures will be undertaken to protect your child’s brain and neurological development. Following the surgery, there will be pediatric cardiac critical care nurses and therapists to give the next stage of treatment in the Cardiac Intensive Care Unit. After the Cardiac ICU stay, your child will be transferred to a dedicated cardiac unit with specially trained cardiac physicians and advanced practice nurse practitioners. During the recovery period, your child will have to come for subsequent follow-up visits and investigations. Post-surgery, therapy and other care will have to be planned.
What are the causes of heart diseases in children ?
The exact etiology of the occurrence of congenital cardiac defects in children still remains a question. Though in some cases, the causes are unknown, in some others the causes can be attributed to genetic association (association with syndromes), consumption of alcohol and drugs during the period of pregnancy and infections during pregnancy (German measles as an instance).
What are the types of heart defects in children ?
The heart abnormalities in children can range from a small hole to defective development of the
heart valves, the heart chambers, the heart muscle and the blood vessels of the heart.
- Patent Ductus Arterious (PDA): Before birth there is a blood vessel in the fetus which runs between the aorta and the pulmonary artery which ideally closes after birth. If this opening does not close after birth it leads to a defect called as patent ductus arteriosus.
- Coarctation of Aorta: A condition where a part of aorta is narrow having an hourglass timer like shape.
- Atrial Septal Defect (ASD): A condition where there is a hole between the left and the right atria or the upper heart chambers.
- Ventricular Septal Defect (VSD): A condition where there is a hole between the two ventricles of the heart or the lower heart chambers.
- Tetralogy of Fallot: It is a congenital defect of the heart when there are four anatomical abnormalities in the heart. The other name for this is the ‘Blue baby syndrome” as the child is affected with cyanosis or inadequate oxygenation of blood.
- Transposition of the heart vessels
- Hypoplastic Left Heart: A poorly developed left heart
- Tricuspid Valve Atresia: A defect in the tricuspid valve (the valve between the upper and lower chambers of the right side of the heart).
- Truncus Arteriosus: A condition wherein the aorta, the coronary arteries and the pulmonary artery all come out from a common trunk instead of the usual separate origins.
What are the symptoms of heart defects in children ?
The heart defects in children may be symptomatic or asymptomatic till the age of adulthood. If the child is experiencing any of the below mentioned symptoms it is advisable to consult a physician or a pediatric cardiologist/cardiothoracic surgeon for further evaluation. The symptoms that may indicate the requirement of surgery are as follows.
- Difficulty in breathing or shortness of breath
- Fatigue
- Bluish discoloration of skin and nails (cyanosis)
- Irregular heartbeats or heart rhythms
- Lack of sleep
- Affected general growth and development of the child
How are the heart defects in children diagnosed ?
If the child is experiencing the above mention symptoms, consultation with a cardiac specialist is the first step advised. The consulting doctor will conduct a thorough clinical examination followed by a series of blood tests (routine blood examination, clotting factors and blood grouping), chest x-ray, echocardiogram, electrocardiogram and cardiac catheterization. It is essential to make the treating doctor aware of any medication the child is taking or any underlying disease for an appropriate diagnosis and treatment of the condition.
What is the procedure of a pediatric heart surgery ?
Some of the heart defects can be treated by a cardiologist without an open heart surgery. These interventional procedures require insertion of a tube near the groin area of the leg and pass them to the heart to correct the defect. Though all the heart defects cannot be corrected by this procedure and require an open heart surgery, where an incision is made through the breastbone and the heart is exposed. A heart lung machine is used to circulate the blood through the body and the heart is temporarily stopped. Once the defect is repaired the heart lung machine is stopped and the heart is started again. The breastbone and the overlying skin are closed with sutures. A sterile bandage is applied over the surgical area. Another procedural technique involves thoracotomy where an incision is made between the ribs on the side of the chest. The heart is accessed with the help of special instruments and a microscopic camera if requires. It is also referred to as closed heart surgery.
What is the post-surgical care in pediatric heart surgery ?
After the surgical procedure the child is shifted to an Intensive care unit (ICU) for at least 3-4 days to monitor the recovery. The vitals are monitored from time to time and an endotracheal tube is used to maintain the airway till the child is comfortable to breathe on its own. Medicines and fluids are administered intravenously. Catheters are used to drain the blood and air in and around the surgical site to avoid any infection. A nasogastric tube is inserted to feed nutrients and empty the stomach. A bladder tube is inserted for drainage of urine. These tubes and catheters are removed usually once the child is moved from an ICU to an inpatient ward. After the doctor feels the condition of the child is stable and he/she can be discharged from the hospital, detailed home care instructions are given. Home care instructions include how to take care of the surgical site, the kind of activities the child can do, the medicines that need to be administered and the schedule for routine follow-ups.
What are the risks of pediatric heart surgery ?
Like any other surgical procedure the common risks include bleeding, infection and blood clots or rare risks like emboli (air bubbles in blood vessels), abnormal heart beats, heart attack or even stroke. Ask the consulting physician or the cardiothoracic surgeon for a detail on the risks and benefits of the surgical procedure before making a final decision on the surgery your child needs.
What is the outcome of a pediatric heart surgery ?
The outcome of heart surgery is multi factorial as it depends on the child’s existing heart condition, the type of heart defect, and the type of surgery that was performed. Many children recover completely and lead normal and active lives. Some children may require multiple surgeries for complete recovery where as some require only one procedure. Hence a detailed discussion between the consulting doctor and the child’s guardian is essential for appropriate diagnosis and treatment planning for the benefit of the child.
How to find pediatric heart surgeons for pediatric heart surgery ?
Now you can find and reach pediatric heart surgeons from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions from multiple pediatric heart surgeons, get approximate cost of pediatric heart surgery from various heart hospitals, compare things and then choose a pediatric heart surgeon or a hospital for pediatric heart surgery.
Find a pediatric heart surgeon for pediatric heart surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
