Types of Paediatric Heart Surgery
When a child is having CHD (congenital heart defects) right from the birth of a child is affected by heart diseases after birth, the treatment is needed for the child’s well being. There are many kinds of heart disorders ranging from minor to severe. These disorders can occur inside the heart or in the large blood vessels located outside the heart. Specific heart defects may not need repair as they can heal as the baby grows while some heart disorders may need surgery right after the child’s birth. There are various types of Paediatric Heart Surgery, and each one has its benefits. Let’s have a look at them.
Patent ductus arteriosus(PDA) ligation: “While in the womb, each baby has a blood vessel called ductus arteriosus, which runs between the aorta and the pulmonary artery. When the baby starts to breathe on his/her own, it will close by itself. If it is opened even after the birth, then it is called a patent ductus arteriosus (PDA).” - A PDA Ligation surgery is required to cure this in case the medicines won’t work out.
How is it done? The surgeon will make a cut on the left side of the chest, and he divides or cuts the ductus arteriosus. This procedure is done in NICU - Neonatal Intensive Care Unit.
Repairment of Coarctation Of the Aorta: “When a part of the aorta becomes narrow - like an hourglass timer, then it will lead to Coarctation of the aorta. The blood flow to the lower parts of the body will be affected by this disorder which in turn results in high blood pressure.” -To repair this defect, doctors usually undergo a surgery.
How is it done? There are many ways to repair this disorder.
- The surgeon cuts the narrow section in the heart, and he will make it bigger with an artificial synthetic patch.
- Sometimes, the surgeon eliminates the narrow section by stitching the remaining ends together.
- Another way to repair the problem is to do a “bypass surgery” In this case, the surgeon connects a tube on either side of the narrow section and provides a bypass to the vital parts of the aorta. Hence, blood flows through the tunnel and bypasses this thin section.
Atrial septal defect (ASD) repair: “When there occurs a hole in Atrial Septum - a wall between the left and right atria of the heart, it is called an ASD.” -When ASD occurs, blood with and without oxygen will mix with each other, leads to various medical problems. Surgery is the best option to repair this disorder.
How is it done? Open-Heart surgery is done to repair ASD. The surgeon will close the septum by stitching it or put a patch on the hole to cover it.
Ventricular septal defect (VSD) repair: “When the hole occurred in the ventricular septum - the wall between the left and right ventricles of the heart, then it will lead to VSD.” -It will also mix the oxygenated blood with used blood. The condition will lead to irregular heartbeats and other heart problems. Surgery is the best option to repair this disorder.
How is it done? In cases where the VSD causes heart failure or endocarditis, open-heart surgery is needed to repair it. Usually, the surgeon closes the hole in the septum with a patch.
Transposition of the great vessels repair: “ When aorta and pulmonary veins originate from extremely other sides of the heart, this transposition leads to many congenital disabilities.”
-Placing those vessels back in their right places require open-heart surgery.
How is it done? The surgeons do an arterial switch to solve the issue. They divide the aorta and pulmonary artery and connect them to where they belong! - pulmonary artery to the right ventricle and the aorta and coronary arteries to the left ventricle.
Truncus Arteriosus Repair: “Truncus Arteriosus is a condition where all three blood vessels - aorta, coronary arteries and pulmonary artery originates from one common trunk.” -It is one of the rarest conditions that occur in the child. The disorder is very complicated, and it requires one or two more surgeries for complete cure.
How is it done? The surgeon separates the pulmonary arteries from the aortic trunk and the patches all the defects. After doing these, the surgeon creates a connection between the right ventricle and the pulmonary arteries.
Tricuspid Atresia Repair: “When the tricuspid valve is deformed, narrowed, or it is missing, then it leads to a disorder called Tricuspid Atresia.”
-Babies who are born with Tricuspid Artesia are ‘blue’ because they cannot receive blood to the lungs. This condition will restrict the circulation of blood to the lungs. Surgery is the only way to repair this problem, but the baby may be given a medicine called prostaglandin E which will keep the patent ductus arteriosus open for a while.
How is it done? The surgeon repairs the tricuspid valve by replacing the lid or put in a shunt so that blood can get to the lungs.
Total anomalous pulmonary venous return (TAPVR) repair: “When the pulmonary veins resend the blood from lungs to the right side of the heart instead of the left side, it is called TAPVR.” -Surgery is the only cure for this disorder, and if the newborn has no severe symptoms, it is done in the first six months of the baby’s life.
How is it done? The surgeon will place the pulmonary veins back to the left side of the heart where they are supposed to be, and he will further check for any abnormal connections. If there is any, he will close that too.
Hypoplastic Left Heart Repair: “If a left heart is very poorly developed, it leads to a disorder called Hypoplastic Left Heart.” -This is a very severe heart defect, and it causes death in most babies if not treated well. Only specialized cardiac medical centres can do this operation, and it usually requires series of three heart operations to attain a complete cure.
How is it done? In the first operation, the surgeon creates a new vessel from the pulmonary artery and the aorta, to carry blood to the lungs and the rest of the body. The second operation is most often done when the baby is 4 to 6 months old followed by the third one at a year after the second operation. With new advances in testing and treatment, most surgeries are successful, and it leads children to healthy and productive lives.