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What Happens After Ventricular Septal Defect Surgery For A Child

What is keyhole heart surgery?

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 childs 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.

How To Prepare For Open

Tell your doctor about any drugs you are taking, even over-the-counter medications, vitamins, and herbs. Inform them of any illnesses you have, including herpes outbreak, cold, flu, or fever.

In the two weeks before the surgery, your doctor may ask you to quit smoking and stop taking blood-thinning medications, such as aspirin, ibuprofen, or naproxen.

Its important to talk to your doctor about your alcohol consumption before you prepare for the surgery. If you typically have three or more drinks a day and stop right before you go into surgery, you may go into alcohol withdrawal. This may cause life-threatening complications after open-heart surgery, including seizures or tremors. Your doctor can help you with alcohol withdrawal to reduce the likelihood of these complications.

The day before the surgery, you may be asked to wash yourself with a special soap. This soap is used to kill bacteria on your skin and will lessen the chance of an infection after surgery. You may also be asked not to eat or drink anything after midnight.

Your healthcare provider will give you more detailed instructions when you arrive at the hospital for surgery.

What Atrial Septal Defect Treatment Is Available

The atrial septal defect treatment depends on the size of the hole in the dividing wall of the left and right atrium. Small children who have ASD may not need treatment if the atrial septal defect is not causing any symptoms. However, if the defect is causing the heart to stretch and enlarge, surgery is usually recommended to close the hole. If the hole is large, common symptoms include heart palpitations, shortness of breath and stroke. When left untreated, ASD may lead to irregular heartbeats, heart failure and lung damage. It is therefore important to seek appropriate atrial septal defect treatment in order to prevent long-term effects.

There are two types of treatment available for ASD: the Amplatzer Device closure method, and keyhole heart surgery. The best treatment for ASD differs from person to person, and procedure that is chosen will depend on the size, location and severity of the defect. At our London Heart Clinic, we offer consultations for atrial septal defects can help determine the best solution for you.

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What Are Some Types Of Heart Surgery

There are many types of heart surgery. The National Heart, Lung, and Blood Institute, which is part of the National Institutes of Health, lists the following as among the most common coronary surgical procedures.

In addition to these surgeries, a minimally invasive alternative to open-heart surgery that is becoming more common is transcatheter structural heart surgery. This involves guiding a long, thin, flexible tube called a catheter to your heart through blood vessels that can be accessed from the groin, thigh, abdomen, chest, neck, or collarbone. A small incision is necessary. This type of surgery includes transcatheter aortic valve implantation to replace a faulty aortic valve with a valve made from animal tissue, MitraClip® placement for mitral valve abnormalities, and WATCHMAN® placement for nonvalvular atrial fibrillation patients.

Why Might My Child Need Ventricular Septal Defect Surgery

What Are The Different Types Of Cardiac Surgeons?

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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How Do I Get Ready For Patent Foramen Ovale Transcatheter Repair

Ask your healthcare provider about how to get ready for this procedure. You should not eat or drink anything after midnight before the day of the procedure. You may also need to stop taking any medicine beforehand.

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

  • Electrocardiogram to look at your heart rhythm
  • Blood tests to check general health
  • Echocardiogram to look at the heart anatomy and blood flow through the heart
  • Transcranial and transmitral Doppler to see the blood moving through the heart
  • Bubble study that is used with the 2 above tests to view the PFO

Hair from around the catheter insertion site may be removed before the procedure.

What Is Asd Closure

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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How Safe Is Pfo Closure & What Is The Recovery Time For It & Can Pfo Closure Cause Afib

Observational data have demonstrated that percutaneous transcatheter closure of patent foramen ovale reduces the risk of cryptogenic and cardiac stroke.1

The patient can go back home on the same day or early next morning after PFO closure however the recovery takes 2-6 weeks to completely resume a normal routine.2

PFO closure has found to have an increased risk on new onset of atrial fibrillation however it occurs early and is transient.3

What Are Holes In The Heart

Repairing the Heart | Cardiothoracic Surgery

Holes in the heart are simple congenital heart defects. Congenital heart defects are problems with the heart’s structure that are present at birth. These defects change the normal flow of blood through the heart.

Your heart has two sides, separated by an inner wall called the septum. With each heartbeat, the right side of your heart receives oxygen-poor blood from your body and pumps it to your lungs. The left side of your heart receives oxygen-rich blood from your lungs and pumps it to your body.

The septum prevents mixing of blood between the two sides of the heart. However, some babies are born with holes in the upper or lower septum.

A hole in the septum between the heart’s two upper chambers is called an atrial septal defect . A hole in the septum between the heart’s two lower chambers is called a ventricular septal defect .

ASDs and VSDs allow blood to pass from the left side of the heart to the right side. This means that oxygen-rich blood can mix with oxygen-poor blood. As a result, some oxygen-rich blood is pumped to the lungs instead of out to the body.

Over the past few decades, the diagnosis and treatment of ASDs and VSDs have greatly improved. Children who have simple congenital heart defects can survive to adulthood and live normal, active, and productive lives because their heart defects close on their own or have been repaired.

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Chd Treatment & Surgeries

Catheter Procedures : Catheter procedures are much easier on patients than surgery. They involve only a needle puncture in the skin where the catheter is inserted into a vein or an artery.Doctors dont have to surgically open the chest or operate directly on the heart to repair the defect. This means that recovery may be easier and quicker.Open Heart Surgery: Sometimes certain heart defects require the chest be opened in order to make repairs or, in rare cases, to make a heart transplant.

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What Are The Risks

Most heart surgeries are major surgeries. Although often successful, they do entail risks. The National Heart, Lung, and Blood Institute identifies some of these risks as:

  • Damage to tissues in the heart, kidneys, liver, and lungs
  • Death, especially for someone who is already very sick before surgery

The risk is higher if you have other diseases or conditions, such as diabetes, peripheral artery disease, or kidney or lung disease.

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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 hearts 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 ASDs dont have strokes and dont need to have their defects closed.

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Treatment Of Secundum Atrial Septal Defect

Conditions

Atrial septal defects can be categorized into several types. Secundum atrial septal defect is the most common type, accounts for 75% of all cases. The hole of secundum atrial septal defect occurs in the middle of the wall between the atria . Small atrial septal defects might close on their own but it is fairly rare. If small atrial septal defects do not cause any problems, they may not require any treatment. But many persistent atrial septal defects eventually require treatments to be corrected. If the size of the hole is between 1 cm. to 3.6 cm. , presented in figure 2, immediate medical attention provided by highly experienced cardiologists must be sought. Effective treatment option is transcatheter ASD closure which is a less invasive procedure to close the wholes with fewer complications and a quicker recovery time.

Transcatheter ASD closure procedure has shown up to 98% treatment success rate with less than 2% of complications. After treatment, patients will be strictly advised on special care and precautions including:

  • Avoid lifting heavy weight at least 1 month
  • Avoid physical activities that need exertion during the first 3 months
  • Anti-platelets will be prescribed for 3-6 months
  • Contraception in female patients in reproductive age group and
  • Taking antibiotic drugs to prevent infective endocarditis during the first 6 months.

Charity project of Bangkok Heart Hospital to treat patients with congenital ASD by using transcatheter ASD closure procedure

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Sleeping Can Be Hard After Surgery

Its hard to find a comfortable position to sleep in. If you are a side or belly sleeper it can be hard laying on your back. Finding your favorite chest pillow will be your savior. You might also experience nightmares for a bit after surgery, but it will pass. If you continue to experience them, speak to your doctor and seek help if you feel like you are experiencing PTSD.

Vsd Repair Requires A Lengthy Recovery

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 patients 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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How Is It Done Or Administered

Surgery done by cutting can be either open-heart surgery or minimally invasive surgery.

  • Open-heart surgery. Most heart defects are repaired with open-heart surgery. The surgeon opens up the chest and repairs the defect using stitches, tubes, or patches, depending on the best solution. You will have anesthesia to put you in a deep sleep so you dont feel any pain. The heart must be stopped from beating during the surgery so the surgeon can do the repair. While the heart is stopped, a heart-lung bypass machine makes sure that you get oxygen and your blood moves through in your body. This surgery requires a hospital stay. After surgery, you may go to the intensive care unit before you are moved to a regular hospital room.
  • Minimally invasive repair with a catheter. With this procedure, the surgeon puts a catheter through an artery in the groin and up to the heart. The surgeon uses imaging, such as x-rays, to see where to place a patch, clip, or another type of repair. This procedure may be done in a hospital, laboratory, or outpatient surgery center.

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

Open Heart Surgery – Preparing for your procedure

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.

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You May Experience Memory Loss And/or Brain Fog

There are a couple of things that can cause memory loss and brain fog after open-heart surgery. If you were put on bypass, it can cause these issues. It is also called pump head. Post-operative cognitive dysfunction can also cause memory loss. Both of these are usually short-term but can have the possibility of long-term effects. For the first six months, I really struggled with memory loss and brain fog. As time went on, it started to get better and I started to regain my memory and wasnt so foggy-headed.

Adult Congenital Heart Defects

A congenital heart defect is a malformation of the heart that is present at birth. Some congenital heart defects are very minor and will never cause health problems. Others are very serious and complicated. These defects are usually discovered in infancy or early childhood due to symptoms and may be surgically repaired at that time.

Adult congenital heart disease normally takes one of two forms: a defect with no symptoms early in life that becomes associated with symptoms later on, or a complex defect repaired during childhood that requires further repair or new treatment in adulthood. Because repaired congenital heart defects can still cause problems later on, patients with a defect repaired in childhood need regular follow-up cardiac care throughout their lives. Occasionally, an adult will experience symptoms of a more complicated defect for the first time as an adult.

The Adult Congenital Heart Clinic at the University of Ottawa Heart Institute takes over the care of patients with congenital heart defects once they become adults.

The most common types of minor congenital heart defects diagnosed in adults are:

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