Paediatric Cardiac Surgery in India

Overview

Paediatric cardiac surgery is a specialised branch of surgery that focuses on the diagnosis, treatment of heart conditions in children. It involves surgical interventions to repair or correct structural abnormalities within the heart, allowing young patients to lead healthier and more fulfilling lives

Types of Paediatric Cardiac Surgery

• Open-heart surgery: This procedure involves making an incision in the chest to access the heart. Surgeons can then repair structural defects, close holes, reconstruct heart valves, or perform other necessary repairs.
• Closed-heart surgery: Also known as minimally invasive cardiac surgery, this technique involves accessing the heart through small incisions, often using specialised instruments and a camera. Closed-heart surgery is often preferred for certain types of defects that can be corrected without directly opening the heart.
• Heart transplantation: In severe cases where the child's heart is irreparably damaged or when other treatment options have failed, a heart transplant may be considered. This involves replacing the child's failing heart with a healthy donor heart.

Why Paediatric Cardiac Surgery is Done

Paediatric cardiac surgery is performed to address various heart conditions present at birth or acquired during childhood. Some common reasons for performing paediatric cardiac surgery include the following:

• Holes in the heart:Certain defects, such as atrial septal defects (ASD) or ventricular septal defects (VSD), involve abnormal openings between the heart chambers. Surgery is often necessary to close these holes and prevent complications.
• Valvular abnormalities: Children can be born with malfunctioning heart valves, such as aortic or mitral valve defects. Paediatric cardiac surgery can repair or replace these valves, ensuring proper blood flow and cardiac function.
• Complex heart abnormalities: Some children have complex congenital heart defects that require intricate surgical procedures to reconstruct the heart's structure. These surgeries aim to improve the child's heart function and overall quality of life.
• Heart rhythm disorders: In certain cases, paediatric cardiac surgery may be performed to correct abnormal heart rhythms, such as atrial flutter or ventricular tachycardia, which can pose significant health risks if left untreated.

Preparation for Paediatric Cardiac Surgery

Before surgery, a comprehensive evaluation is conducted, which typically includes the following:

• Medical history and physical examination: The child's medical history, current health status, and any associated conditions are assessed. A physical examination may be performed to evaluate the child's overall health and heart condition.
• Diagnostic tests: Imaging techniques, such as echocardiography, cardiac MRI, or cardiac catheterisation, are used to obtain detailed information about the heart's structure and function, aiding in surgical planning.
• Blood tests: Blood samples are collected to assess the child's blood count, coagulation profile, and overall health status.

Procedure of Paediatric Cardiac Surgery

The specifics of the procedure depend on the child's condition, the type of surgery, and the surgeon's approach. However, here is a general outline of the surgical process:

• Anaesthesia: The child is administered general anaesthesia to ensure they are asleep and pain-free during the surgery.
• Incision: The surgeon makes an incision in the appropriate location, which may be in the chest or through smaller incisions in minimally invasive surgery.
• Cardiopulmonary bypass (CPB): If open-heart surgery is performed, the child is connected to a heart-lung machine, which temporarily takes over the heart's pumping and oxygenation functions. This allows the surgeon to operate on a motionless and bloodless heart.
• Surgical repair: The surgeon performs the necessary repairs or corrections to the heart defects, such as closing holes, reconstructing valves, or redirecting blood flow.
• Weaning from CPB: Once the repairs are completed, the child is gradually disconnected from the heart-lung machine and the heart is allowed to resume its normal function.
• Closure: After verifying that the heart is functioning properly, the surgeon closes the incisions using sutures or other closure techniques.

Recovery and Complications

The overall recovery time varies depending on the complexity of the procedure and the child's individual response.

Complications associated with paediatric cardiac surgery can include:

• Bleeding: Surgical procedures involving the heart carry a risk of bleeding. In some cases, additional interventions or blood transfusions may be required to manage excessive bleeding.
• Infection: Surgical sites or the heart itself can become infected, requiring appropriate antibiotic treatment.
• Arrhythmias: Irregular heart rhythms may occur after surgery, necessitating further treatment or medication to restore normal rhythm.
• Fluid accumulation: Fluid may accumulate around the heart or lungs, potentially causing respiratory difficulties. This may require drainage or medication.
• Poor wound healing: In some cases, the incisions may heal slowly or become infected, requiring additional care and treatment.

If your child is facing a congenital heart defect or other cardiac condition, don't hesitate to reach out to our experienced paediatric cardiac surgery team. Our skilled surgeons and dedicated medical staff are here to provide the best possible care for your little one. Contact us today to schedule a consultation and take the first step towards improving your child's heart health.