Successful heart surgery at We Care India partner hospital allows Robert Clarke to live a normal life despite a rare genetic disorder We Care india helped Robert find best super specialised surgeon for his rare condition.
The heart is divided into four chambers. The upper chambers are the atria and the lower chambers are the ventricles. The right side of the heart right atrium and right ventricle pumps blood to the lungs to pick up oxygen and the left side of the heart takes this oxygen-rich blood and sends it throughout the body. The system works very well when the right and left sides of the heart are separated by heart muscle in the middle, a muscle known as a septum. When there is a hole in the wall between the two ventricles, it is known as a ventricular septal defect. By extension, the surgery to repair this congenital heart abnormality is called ventricular septal defect closure.
Ventricular Septal Defect Closure
Causes, incidence, and risk factors
Before a baby is born, the right and left ventricles of its heart are not separate. As the fetus grows, a wall forms to separate these two ventricles. If the wall does not completely form, a hole remains. This hole is known as a ventricular septal defect, or a VSD.
It is estimated that up to 1% of babies are born with this condition. The baby may have no symptoms, and the hole can eventually close as the wall continues to grow after birth.
If the hole is large, then too much blood will be pumped to the lungs, leading to congestive heart failure. These babies are often have symptoms related to heart failure and may need medicine to control the symptoms and surgery to close the hole.
The cause of VSD is not yet known. This defect often occurs along with other congenital heart defects.
In adults, interventricular septal defects are a rare, but serious complication of heart attacks. These holes are related to the heart attack and do not result from a birth defect.
Symptoms
Shortness of breath
Fast breathing
Hard breathing
Paleness
Failure to gain weight
Fast heart rate
Pounding heart
Sweating while feeding
Frequent respiratory infections
Signs and tests
Listening with a stethoscope usually reveals a heart murmur (the sound of the blood crossing the hole). The loudness of the murmur is related to the size of the defect and amount of blood crossing the defect.
Tests may include : -
Chest x-ray : - looks to see if there is a large heart with fluid in the lungs
ECG : - shows signs of an enlarged left ventricle
Echocardiogram : - used to make a definite diagnosis
Cardiac catheterization : - (rarely needed, unless there are concerns of high blood pressure in the lungs, in which case surgery to close the defect is generally not recommended)
What happens on the day of surgery?
For patients who are hospitalized the night before surgery, an intravenous (IV) catheter may be placed. This will allow intravenous fluids to be given once NPO (nothing by mouth) status begins.
All patients whether they are admitted to the hospital or not - will be placed on "NPO" (nothing by mouth) status after midnight the night before surgery. Clear liquids may be allowed at the specific instructions of the anesthesiologist.
On the morning of surgery, your family will meet our staff. You will be greeted by a receptionist and given a private waiting room. Approximately one hour prior to surgery, the patient will be taken to the holding area, dressed in hospital pajamas, and placed in a crib or bed. The anesthesiologist will order some medication to be given that reduces anxiety. This medication is given by mouth or IV, and will allow the patient to relax and become sleepy.
What type of anesthesia will be used?
Anesthesiologists who specialize in pediatric cardiovascular anesthesia will manage the anesthetic care of the patient throughout the surgery. They collaborate closely with the surgeon and the rest of the OR team to monitor and manage the patient's care in the operating room. Based on their pre-operative assessment, they will individualize the anesthetic to meet each patient's physiologic needs. In most cases, a general anesthetic approach is used which results in the patient being completely unconscious and pain-free during the entire surgery as well as shortly afterward. During the surgery, several specialized neurophysiologic monitors are used to ensure that the anesthesia is effectively maintaining the patient in a fully unconscious and pain-free condition.
What happens during surgery and how is it performed?
The type of surgery your child will undergo depends on your child's heart defect. Prior to the surgery, the surgeon will have a detailed consultation with the family to explain the specific surgical procedure, discuss risks and benefits, and answer any questions the family may have. Throughout the actual operation, a surgical nurse clinician will update the family approximately every hour during your child's surgery. These updates will be given in the private waiting room assigned by the receptionist.
How long will we be in the hospital?
The length of time in the hospital will depend on a variety of factors : -
The type of congenital heart defect, surgical repair and post-operative course
The patient's ability to maintain/gain weight and activity level
The family's understanding and ability to provide for the patient's post-operative needs
In general, patients can expect to stay anywhere from 3-10 days, depending on the above factors. Patients who live greater than an hour's drive from Houston may need to make arrangements to stay in the Houston area until after their 1st post-operative cardiology clinic visit (1 week after discharge).
What are the risks associated with congenital heart surgery?
Risks associated with congenital heart surgery vary widely according to the specific procedure and the patient's condition at the time of surgery. They can include:
Bleeding
Infection
Need for re-operation
Damage to nerves in the chest area
Brain damage
Death
Your surgeon will discuss the specific risks associated with your child's congenital heart surgery at the time of your consult. In our program, the risk of serious complications occurring, such as brain damage or death, is very low. Our surgeons have a very large experience and can provide specific data to you defining the surgical risk for your particular procedure. We believe this important information must be shared with parents to make the process less stressful.
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The heart is divided into four chambers. The upper chambers are the atria and the lower chambers are the ventricles. The right side of the heart right atrium and right ventricle pumps blood to the lungs to pick up oxygen and the left side of the heart takes this oxygen-rich blood and sends it throughout the body. The system works very well when the right and left sides of the heart are separated by heart muscle in the middle, a muscle known as a septum. When there is a hole in the wall between the two ventricles, it is known as a ventricular septal defect. By extension, the surgery to repair this congenital heart abnormality is called ventricular septal defect closure. 
