Grownup Congenital Cardiac Surgeries

GROWNUP CONGENITAL CARDIAC SURGERIES

Overview

The term Congenital refers to having a trait, habit or a disease right from birth. So when we mention Congenital Cardiac Issues, we are actually referring to a host of heart related problems that an individual may have right from their birth. Most of the congenital cardiac issues are treated in the childhood itself, hence paediatric cardiology is a super speciality in the field of Cardiology. While the doctors try to correct as many as possible conditions in young children, there is always a possibility that some of the congenital diseases have not been treated by surgery in the patient’s childhood for a variety of reasons. This is why, grown up congenital cardiac surgery is rapidly evolving as a sub speciality of Congenital Cardiology. So, what are these congenital cardiac conditions which need congenital heart disease treatment? Before we get into the details of these diseases, it is helpful to understand how the human heart functions. The human heart is made up of four chambers – left atrium, left ventricle, right atrium and right ventricle. The blood flows from body to the lungs and from the lungs back to the body by means of these chambers. The flow of the blood is controlled by the different valves that allow only the required amount of the blood to flow.

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Now, let us look at the different Congenital Cardiac Diseases

1. Atrial Septal Defect – The left and the right atria are the upper chambers of the heart that are separated by a wall known medically as atrial septum. When this wall has a hole, the oxygen rich blood from the lungs gets mixed with the oxygen poor blood flowing towards the lungs. This causes insufficient supply of blood to the body and is known as Atrial Septal Defect.

The Atrial Septal Defect can be closed with the help of a closure device, though in some cases it may require an open heart surgery, to close the defect with stitches. In such a case, the congestive heart failure treatment may be deferred till the child grows up. 

2. Ventricular Septal Defect – Just like the atria, the two ventricles (lower chambers) of the heart are separated by a wall called the Ventricular Septum. A hole in the Ventricular Septum is called Ventricular Septal Defect. It may lead to mixing of oxygenated and deoxygenated blood causing irregular heartbeats and other problems.

The Ventricular Septal Defect is also treated by the help of Congenital Cardiac Surgery, though an open heart surgery may not be required. Generally, the VSD closes on its own by the time the child turns one. In case it does not, it may need to be closed surgically. The cardiologist is the best person to take a call, whether an open heart surgery is required or not.

3. Patent Ductus Arteriosus – Before a child is born, there is a blood vessel that directly connects its aorta to the pulmonary artery. This blood vessel is known in the medical world as Ductus Arteriosus. Once the baby is born and starts breathing on its own, this vessel closes on its own. If however, this vessel does not close on its own, it needs to be surgically closed or cut, so that there is no short circuit for the supply of blood.

Generally, this particular congestive heart failure treatment does not need surgery, but can be done with the help of Cardiac Catheterization. Alternatively, this can be done using minimally invasive cardiac surgery.

4. Coarctation of the Aorta – The aorta is the biggest blood vessel in the human body and is responsible for regulated flow of oxygenated blood to all parts of the body. When a particular cross section of the aorta narrows down in the middle, like an hourglass, it leads to insufficient supply of blood.

An advancement in medical technology has led to the development of a newer method called CT Angiography, which is a non-invasive method of getting an angiogram. As opposed to the traditional coronary angiography, the CT angiogram doesn’t involve the use of catheter, but relies on extremely powerful X-Ray imaging.

Like any other medical procedure, the angiogram test carries its own set of risks that include bleeding at the wound, chances of infection, bruising and swelling in some cases. Although, none of it is major, it is strongly advisable to consult the doctor in case of any doubts.

This condition can be treated by many ways of Congenital Heart Failure Treatment
  • Cutting the narrow section and widening it with the help of synthetic material
  • Removing the narrow section completely and connecting the upper and lower sections
  • Creating a subclavian flap to allow better flow of blood
  • Bypassing the narrow section, by connecting the upper and lower portions with the help of a tube
  • Stenting

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