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Pediatric Cardiac Surgery

Pediatric Cardiac Surgery is carried out in children who have congenital heart defects. These are the most common birth defects which affect the normal blood flow through the heart due to disorders related to the valves, walls and blood vessels of the heart. A pediatric cardiac surgery is required in the case of improper closing of the valves, perforation in the atria or ventricles and poor connection in blood vessels causing flow of blood in the wrong direction. Congenital Heart Defects (CHD) occur as a result of genetic abnormalities such as Down Syndrome, drug abuse or infections in the mother during the first trimester of pregnancy. 

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Symptoms

There are several symptoms of Congenital Heart Disease:

  • Difficulty in breathing
  • Cyanosis- Lips, skin and nail beds turn blue / gray
  • Arrhythmia 
  • Poor development and growth of child
  • Fatigue and weakness
  • Child does not gain weight
  • Difficulty in exercising
  • Infections in the lung

Diagnosis

Congenital Heart Defects can be diagnosed during pregnancy or after birth. Echocardiogram is an ultrasound which uses sound waves to produce images of the heart. Cardiac catheterization can also be helpful to diagnose abnormalities in the heart by inserting a catheter through a blood vessel to reach the heart. The heart’s electrical activity can be measured by an electrocardiogram to see if there are any irregularities. Chest X-rays can also be done to find disorders in the heart.

Treatment

There are several ways of treating Congenital Heart Defects such as -

  • Catheter procedures in which a catheter, a small flexible tube, is inserted through a blood vessel in the arm and is made to reach the heart. This does not require an incision to be made in the chest to operate on the heart and hence is a better method. This also reduces the recovery time for the patient. This procedure is commonly used for Septal defects and Valve stenosis. The catheter is guided up till the heart with the help of echocardiography.
     
  • Open heart surgery in which a large incision is required to be made in the chest to operate defects that cannot be treated by catheter procedures. This method is often used for holes in the heart, dysfunctional heart valves and to repair complex defects. The patient is connected to a heart-lung bypass machine to regulate blood flow meanwhile the heart is being operated upon.  

Risks

There are several risks involved in Pediatric cardiac surgeries. There may be a lot of bleeding during the surgery and possibilities of infections. Blood clots or air emboli may also form in the blood vessels during operation. Arrhythmia may occur due to some complications in surgery and might further lead to a stroke or heart attack. 

After Procedure

The child is required to stay in the hospital for at least 2 – 4 days after the cardiac surgery. The recovery time is less for procedures involving a catheter as compared to open surgery. In the long run, children who have had surgery need to limit the type and quantity of exercise they do. Extra measures may have to be taken in order to prevent infections such as endocarditis as children who have undergone surgery are more prone to these.

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