Congenital heart surgery is done for treatment of congenital heart defects (defects that a child is born with/defects present at birth) that adversely affect a child’s health. Congenital heart defects can affect the heart valves, arteries and veins carrying blood to the heart and away from the heart to the other parts of the body and/or septum that separate heart chambers.
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Congenital heart surgery is recommended for complex and life threatening congenital heart defects. It may be needed in cases of:
Medium to large atrial septal defects (ASD) that do not close on their own. ASD is a hole in the septum that separates the upper chambers of the heart i.e. the atria
Large ventricular septal defects (VSD). A VSD is a hole in the septum that separates the lower chambers of the heart i.e. the ventricles
Severe pulmonary valve stenosis (narrowing of pulmonary valve)
Complex heart defects like tetralogy of fallot: combination of pulmonary valve stenosis, a large ventricular septal defect, an overriding aorta and right ventricular hypertrophy
Echocardiography is done to create a moving picture of the heart. Echo helps in diagnosing the problem, following it over time and in deciding that when treatment is needed. Fetal Echo may be advised by the doctor if congenital heart defects are suspected during pregnancy. Electrocardiogram testing may be done to record the heart’s rhythm. A chest x ray may also be advised. Cardiac catheterization may be done to see the flow of blood through the heart and view the blood vessels on an x ray image.
The surgery is performed by pediatric cardiac surgeons. Cardiac catheterization is done to repair some heart defects. A thin flexible tube called a catheter is inserted in a vein in the arm, upper thigh or neck which is then threaded to the heart. A dye is injected through this catheter which flows to blood vessels and chambers of the heart and this allows the doctor to see the x ray image of these vessels. Catheterization is commonly used for treatment of atrial septal defect and pulmonary valve stenosis. An open heart surgery may be required when cardiac catheterization cannot be done. Biological materials or manmade/synthetic materials may be used to repair defects. The child may be put on heart lung bypass machine during the surgery.
Recovery is faster with catheter procedures as chest need not be surgically opened. Complete recovery can take several weeks. There will be pain post surgery which will take a few days to weeks to completely subside.
Activities like cycling, skating and swimming that can hurt the chest must not be done till allowed by the doctor.
The child will be irritable and will need support from the caregivers to return to daily activities.
Risk and Complication
There is risk of excessive bleeding, infection and reaction to anesthetic drugs. The nerves in the chest area may be damaged.
It may also be called as congenital cardiovascular surgery.
Some congenital defects are small & asymptomatic and do not require any surgical treatment.
Those who have complex congenital heart defects may need several catheterizations and surgeries over a period of time.
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