Pediatric cardiac surgery is a surgical procedure done to repair heart defects in children and ensure their wellbeing. These could be congenital; that is, the child could be born with them or develop in a child after birth.
A single surgery may often be enough to repair the heart defect, but sometimes, a series of procedures may be required for this purpose. The most commonly performed pediatric cardiac surgeries are –
- Open – heart surgery
- Thoracotomy or closed–heart surgery
- Complete intracardiac repair
- Heart valve repair and replacement
- Staged reconstructive surgery
Do you know how serious is Congenital Heart Disease? the estimated number of children born with congenital heart disease in India is more than 200,000 per year.Indian Pediatr. 2018 Dec 15
How is Pediatric Cardiac Surgery performed? :
Open–heart surgery is the major invasive procedure that is done to repair heart defects in children. During this surgery, the child is anesthetized, and an incision is made through the breastbone or sternum. The child is then connected to a heart-lung bypass machine that pumps oxygenated blood throughout the child’s body while the heart is repaired. By using this machine, the surgeon can stop the heart till the completion of the procedure. Usually, the surgeon repairs the heart muscle itself, the heart valves, or the blood vessels outside the heart during this surgery and finally removes the machine and closes the skin incision made near the breastbone.
In contrast to this surgery, closed heart surgery is done via incisions made from the side, between the ribs. It doesn’t involve using a heart-lung bypass machine, but the surgeon may use some special instruments and a camera occasionally. Most cardiac surgeries are done only once to rectify the heart defect. However, if the child is born with many types of ventricle heart defects, then a series of procedures, usually three, are done to correct this. It is called “staged reconstructive surgery.” In this surgery, the baby’s heart and circulatory system are reconfigured, starting from several days of birth to 1.5 to 3 years of birth.
Why is Pediatric Cardiac Surgery performed? :
Pediatric cardiac surgeries are typically done to treat congenital heart defects and other rare heart conditions in pediatric patients of all ages.
Very few heart defects demand immediate surgical repair, while cardiologists can manage other conditions with medicines and lifestyle changes for some years. Surgery is generally opted for when the child experiences difficulty breathing, such as when the lungs get congested, has blue or gray skin, nails or hypoxia, and has abnormal heart rhythms.
Some of the heart conditions that require these surgeries are :
- Aortopulmonary window
- Atrial and ventricular septal defects
- Coarctation of the aorta
- Cor triatriatum
- Double outlet right ventricle
- Coronary fistulas
- Ebstein’s anomaly
- Heart tumors
- Mitral valve stenosis and regurgitation
- Patent ductus arteriosus
- Pulmonary valve stenosis and regurgitation
- Single ventricle disease
- Tetralogy of Fallot
- Truncus arteriosus
- Valve repair
Are there any risks involved in it? :
Pediatric cardiac surgery is associated with severe complications such as bleeding, blood clots (thrombi), pulmonary embolism, pneumonia, infections, breathing problems, systemic inflammation, arrhythmias, heart attack, stroke, seizure, and even death cases.
FAQs: Pediatric Cardiac Surgery
- What are preparations required from the patient?
The child is thoroughly examined by the cardiologist and cardiac surgeon for preoperative testing. It is done by carrying out chest x – rays, echocardiogram, electrocardiogram (ECG), cardiac catheterization, and blood tests. The parent/ guardian and the child are generally expected to come to the hospital a week before the day of the surgery for counseling. Consult with the physician to know what medications the child can take before the surgery, especially if they are taking blood thinners. The child is often asked to avoid eating or drinking anything after midnight the night before the surgery.
- Which are the Blood Tests for diagnosing cardiac diseases?
- What is ECG, and how is it performed?
- Cardiac Catheterization
- How long does it take?
The child will be admitted the day before or the morning of the surgery and will typically stay in the hospital till the child recovers completely. The duration of pediatric cardiac surgery depends on the child’s heart condition and the procedure that is being performed. The commonly performed pediatric open-heart surgery usually takes around 3 to 6 hours to complete.
- Who performs it?
Pediatric cardiac surgery is performed by a team of healthcare professionals, including cardiologists, cardiovascular surgeons, pediatric anesthesiologists, intensive care specialists, perfusionists (specially trained individuals who operate the heart-lung machine), and nurses.
- How much does it cost?
It generally costs around INR 1.5 L to 3 L to get a pediatric open-heart surgery done in India.
- When can I go home after the procedure?
Most children who get open–heart surgery stay in the intensive care unit (ICU) for 2 to 4 days after the surgery and hospitalization for about seven days after leaving the ICU. Following this, they are allowed to go home but are instructed to rest for a few weeks before going back to their routine.