Tuesday, November 29, 2022

Heart Hole Repair Surgery

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Surgery to Repair Hole in Patient’s Heart

Depending on the type of ASD, your child’s pediatric cardiologist may examine your child periodically to look for uncommon problems. For a short time after surgery to close an ASD, a pediatric cardiologist must regularly examine the child. The long-term outlook is excellent, and usually no medicines and no additional surgery or catheterization are needed.

What Is Patent Foramen Ovale Transcatheter Repair

A patent foramen ovale is a small hole between the two upper chambers of the heart, the right and the left atrium. Patent foramen transcatheter repair is a procedure to fix this hole in the heart.

Normally, the atrial septum separates the right and left atria. No blood flows between these 2 chambers. If a PFO exists, a little blood can flow between the atria. This flow of blood between the atria is not normal. This hole is normally present in the heart before birth. But in most people, it closes soon after birth.

During transcatheter repair, a healthcare provider inserts a device that can plug up the PFO. This device attaches to the end of a long, flexible tube called a catheter. The healthcare provider inserts the catheter through a blood vessel in the groin and guides it to the PFO. He or she uses the device to fix the hole and then removes the catheter from the body.

What Happens After Ventricular Septal Defect Surgery For A Child

Ask your childs healthcare provider what will happen after the VSD surgery. In most cases, the surgery will permanently cure the VSD. No activity restrictions will be needed. After the procedure in the hospital, you can generally expect the following:

  • Your child may spend several hours in a recovery room. Or the surgery team may take him or her straight to the intensive care unit.
  • Medical staff will closely watch your child’s heart rate, blood pressure, oxygen levels, and breathing.
  • Your child will get pain medicine if needed.
  • Your childs healthcare provider may order follow-up tests, like an electrocardiogram or an echocardiogram.
  • Your child will probably be able to go home about a week after surgery.

At home after the procedure:

  • Ask what medicines your child needs to take. Your child may temporarily need to take certain medicines after the surgery. Give pain medicines as needed.
  • Most children can get back to their normal activities when they get home. But they may tire more easily for a while. Children should avoid activities that might result in blows to the chest.
  • Your child may need to have stitches removed in a follow-up appointment. Be sure to keep all follow-up appointments.
  • Follow all the instructions your childs healthcare provider gives you about medicine, exercise, diet, and wound care.
  • For a while after the procedure, your child might also need antibiotics before certain medical and dental procedures. They can help prevent an infection of the heart valves.

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How Do I Help My Child Get Ready For Ventricular Septal Defect Surgery

Ask your childs healthcare provider how to help your child get ready for VSD repair. Your child should not eat or drink anything after midnight before the day of the surgery. Your child may also need to stop taking any medicine beforehand.

Your childs healthcare provider may want some extra tests before the surgery. These might include:

  • Electrocardiogram, to look at the heart rhythm
  • Blood tests, to check general health
  • Echocardiogram, to look at heart anatomy and blood flow through the heart

What Is Asd Closure

What are the Risks of Going through Hole in Heart Surgery?

ASD closure is a procedure to close an atrial septal defect or hole in your heart.

An atrial septal defect is an abnormal opening in the wall between your hearts two upper chambers . Every baby is born with a small opening there. The hole usually closes a few weeks or months after birth. But sometimes a baby is born with a larger hole that doesnt close properly.

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What Happens During Patent Foramen Ovale Transcatheter Repair

Talk with your healthcare provider about what to expect. Your procedure may vary depending on the kind of echocardiogram the healthcare provider uses. A cardiologist and a team of specialized nurses will do the procedure, usually in a cardiac catheterization lab. In general:

  • A healthcare provider will probably give you anesthesia before the surgery starts. You will sleep deeply and painlessly during the operation. You wonât remember it afterward.
  • The repair will take about 2 hours.
  • The healthcare provider inserts a small, flexible tube into an artery in the groin. This tube will have a small device inside it.
  • The provider threads the tube through the blood vessel all the way to the PFO.
  • The provider may use X-ray images and an echocardiogram to see exactly where the tube is.
  • The provider will push the small device out of the tube and plug the hole in the PFO. Then the device will be secured in place.
  • The provider will remove the tube through the blood vessel.
  • The insertion site will be closed and a bandage will be applied.

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Hurry To Admit Wait To Operate

Treating VSD percutaneously requires a “hurry up and wait” strategy. If we operate too soon, we risk making the VSD larger. If we wait too long, the patient’s health may decline too much to save the heart. Expertise is required to carefully time the performance of the procedure, which balances delicacy with a certain amount of force.

A found that operating within seven days of a heart attack resulted in a 54.1% mortality rate in patients with hemodynamic compromise, or inability of the heart to pump enough blood. Operating after seven days dropped the death rate to 18.4%.

If we operate too soon, the hole could expand larger than the closure device that we are attempting to close the hole with, ultimately causing more damage. Well monitor you closely during this time until the VSD appears to be done expanding.

In some patients it can take up to three weeks for the tissue around the VSD to become stiff enough to anchor the surgical sutures. But waiting also takes a toll on the patient’s health. In some cases, kidney function decreases due to low blood flow. The patient may need dialysis to keep fluid off their kidneys or lungs, and mechanical support to maintain heart function, such as a balloon pump.

Suffice it to say, the monitoring process is a delicate balance that requires sharp clinical judgment we wait to operate until we cannot wait any longer.

Vsd Repair Requires A Lengthy Recovery

Atrial Septal Defect Repair at SSM Heart Institute

For every day a patient is sedentary with illness, it takes approximately a week to regain lost strength. This could mean several months of recovery for the patient after they have been discharged from the hospital.

So, after the VSD closure, patients must diligently perform physical therapy to rebuild their muscles and improve their nutrition.

UT Southwestern offers a strong Cardiac Rehabilitation program to help patients recover after heart surgery or heart failure. The dietitians, physical therapists, and other specialists track the patient’s progress, helping them grow stronger and reduce their risk of future heart problems.

Percutaneous VSD closure is a complex, major procedure and a lengthy, strenuous experience that can be avoided. Please go to the emergency room at that first sign of heart attack. There is no reason to wait when your life is at stake.

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What Else Should I Know

In the weeks after surgery or cardiac catheterization, the cardiologist will check on your child’s progress. Your child might have another echocardiogram to make sure that the heart defect has closed completely.

Most kids recover from treatment quickly, and will just need regular follow-up visits with their cardiologist. You might even notice that within a few weeks, your child is eating more and is more active than before surgery.

However, some signs and symptoms might indicate a problem. If your child is having trouble breathing, call the doctor or go to the emergency department immediately. Also call the doctor if your child has any of these symptoms:

  • a bluish color around the mouth or on the lips and tongue
  • poor appetite or difficulty feeding
  • failure to gain weight or weight loss
  • listlessness or decreased activity level
  • a lasting or unexplained fever
  • increasing pain, tenderness, or pus oozing from the incision

Having your child diagnosed with a heart condition can be scary. But the good news is that your pediatric cardiologist will be very familiar with ASDs and how best to manage the condition. Most kids who’ve had an ASD corrected go on to live healthy, active lives.

The care team is there to support you and your child. Be sure to ask when you have questions.

You also can find more information and support online at:

What Happens During Heart Valve Repair Or Replacement Surgery

Heart valve repair or replacement surgery requires a stay in a hospital.Procedures may vary depending on your condition and your healthcareproviders practice.

Generally, open-heart valve repair or replacement follows this process:

  • You will be asked to remove any jewelry or other objects that may interfere with the procedure.

  • You will change into a hospital gown and empty your bladder.

  • The surgical team will position you on the operating table, lying on your back.

  • A healthcare professional will start an intravenous line in your arm or hand for injection of medicine and to give IV fluids. More catheters will be put in blood vessels your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples.

  • The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.

  • Your doctor will put a breathing tube through your mouth into your lungs and connect you to a ventilator, a machine that will breathe for you during the surgery.

  • Your doctor will place a transesophageal echocardiogram probe into your esophagus so he or she can monitor the function of the valves.

  • A soft, flexible tube will be put into your bladder to drain urine.

  • A tube will be put through your mouth or nose into your stomach to drain stomach fluids.

  • Someone on the surgical team will clean the skin over your chest with an antiseptic solution. If there is a lot of hair at the surgical site, it may be shaved off.

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    What Is Atrial Septal Defect

    An atrial septal defect is a birth defect of the heart in which there is a hole in the wall that divides the upper chambers of the heart. A hole can vary in size and may close on its own or may require surgery. An atrial septal defect is one type of congenital heart defect. Congenital means present at birth.

    As a babys heart develops during pregnancy, there are normally several openings in the wall dividing the upper chambers of the heart . These usually close during pregnancy or shortly after birth.

    If one of these openings does not close, a hole is left, and it is called an atrial septal defect. The hole increases the amount of blood that flows through the lungs and over time, it may cause damage to the blood vessels in the lungs. Damage to the blood vessels in the lungs may cause problems in adulthood, such as high blood pressure in the lungs and heart failure. Other problems may include abnormal heartbeat, and increased risk of stroke.

    Who Performs An Atrial Or Ventricular Septal Defect Repair

    Ventricular Septal Defect (VSD)

    A cardiac surgeon or an interventional cardiologist performs an atrial or ventricular septal defect repair. Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons. Interventional cardiologists specialize in diagnosing and treating heart disease using catheter procedures and radiological imaging.

    If your child needs an atrial or ventricular septal defect repair, a pediatric cardiac surgeon or pediatric interventional cardiologist will perform the procedure.

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    What Are The Risks Of Ventricular Septal Defect Surgery For A Child

    Most children do well with VSD surgery. But complications do sometimes develop. Specific risk factors may vary based on age, the size of the defect, and other health problems. Possible risks include:

    • Excess bleeding
    • Blood clot, which can lead to stroke or other problems
    • Abnormal heart rhythm, which can rarely cause death
    • Heart block, which can make a pacemaker necessary
    • Complications from anesthesia

    Late complications are also possible. But they are rare. These might include problems with the heart valves. Very rarely, the patch used to fix the defect might become loose, requiring another surgery. Ask your childs healthcare provider about the specific risk factors for your child.

    Problems You May Have

    People with small unrepaired or repaired atrial septal defects rarely have any late problems. Those who have palpitations or who faint need to be evaluated by their cardiologist and may need medical therapy. Also, if the ASD is diagnosed late in life, the heart’s ability to pump may have been affected, leading to heart failure. This condition can require diuretics, drugs to help the heart pump better and drugs to control blood pressure. If pulmonary hypertension develops , some people may need extra medications.

    Patients who have had a transient ischemic attack or a stroke and are found to have a PFO may be treated with aspirin or another *blood thinner. If another stroke recurs on medicines, patients may be referred to have a PFO or small ASD closed . There are now special studies in progress to determine whether medications or closure of the PFO is better at preventing stroke. It is important to emphasize that the vast majority of people with small PFOs and ASD’s don’t have strokes and don’t need to have their defects closed.

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    What Happens During Surgical Asd Closure

    During surgery for ASD closure, youre under general anesthesia. You receive medications that put you to sleep, so you feel no pain during the operation.

    A healthcare provider connects you to several machines that monitor your vital signs, including heart rate and breathing. They also connect you to a heart-lung machine to take over the work of your heart during the procedure.

    Your heart surgeon makes an incision in your chest. Your surgeon may make the incision:

    • Down the middle of the chest over your breastbone.
    • On the right side of your chest.
    • In another location determined by your surgeon.

    Your surgeon then uses a special tool to spread your ribs. Using an endoscope, a thin tube with a light and camera at the end, your surgeon locates the ASD. Then they close it with a plug, patch or sutures.

    How Does The Asd Affect My Child

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    Children with an ASD often have no symptoms. If the opening is small, it won’t cause symptoms because the heart and lungs don’t have to work harder. If the opening is large, the only abnormal finding may be a murmur and other abnormal heart sounds. In children with a large ASD, the main risk is to the blood vessels in the lungs because more blood than normal is being pumped there. Over time, usually many years, this may cause permanent damage to the lung blood vessels.

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    After Heart Attack This Rare Procedure Can Save Patients From A Hole In The Heart

    Heart attack symptoms should be considered an emergency under any circumstance you cant take chances with the hardest working muscle in your body.

    In the ER, we can quickly assess the damage, potentially stop the heart attack, and save your life, whether you are experiencing unstable angina or having heart attack from a blocked artery.

    Waiting to seek emergency care, however, can have a range of dire consequences. Among them is a complex condition called acquired ventricular septal defect a tear in the heart that is fatal for 25% of patients within 24 hours of when it forms.

    The insidious hole, also known as a ventricular septal rupture , affects approximately 1 in 1,000 patients who dont seek care within a week of experiencing heart attack symptoms. Nearly all those patients die within a year if they don’t receive care for this condition.

    But there is hope for lifesaving treatment. If a patient can get to an academic medical center quickly, or at least within two weeks after a heart attack, we can potentially repair the rupture with percutaneous VSD closure an advanced, catheter-based alternative to open heart surgery. William P. Clements Jr. University Hospital is one of fewer than 10 Texas hospitals that offer this advanced procedure.

    Why Might My Child Need Ventricular Septal Defect Surgery

    The purpose of this surgery is to ease symptoms caused by the VSD and to prevent future symptoms. No one knows what causes most cases of this common heart defect.

    Not everyone with a VSD needs to have the hole repaired. Very small holes in the ventricular septum may not let much blood pass between the ventricles. In these cases, the heart and lungs dont have to work harder and no repairs are needed. These smaller holes dont cause any symptoms. Sometimes these small holes will close up on their own naturally. Your childs healthcare provider might wait to see whether that happens before planning to do a repair, especially in a very young child.

    If your child has a larger VSD, he or she may need some type of repair. Infants and children with larger VSDs often have symptoms like breathing faster and harder than normal. They may also fail to gain weight normally. A large, unrepaired VSD can eventually cause elevated pressure in the blood vessels in the lungs. The higher pressure can lead to decreased oxygen levels in the body.

    Healthcare providers often recommend some type of repair for children who have a large VSD, even if they dont have symptoms yet. It can prevent long-term damage to the lungs. Healthcare providers often do the surgery in infants or children. Sometimes adults also need this type of repair if their VSD was not found during childhood.

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