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:
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 Patent Foramen Ovale And How Is It Treated
This type of hole in the heart is something that occurs in infancy. As a baby in utero, there is a hole in the heart tissue that separates the left and right chambers, also known as the interatrial septum. This hole is called a foramen ovale and it exists to allow blood to bypass the fetal lungs since they dont work until exposed to air. However, once born, this hole naturally closes at birth and if it doesnt, the hole that continues to exist is known as a PFO.
This type of hole is often small in size, and, in most cases, the only effect of a PFO is blood leaking between the right and left chambers. Unless a PFO is detected during childhood, it may go undetected for years, until a person experiences conditions like migraine or stroke that require careful investigation and diagnosis.
Most PFOs require minimal treatment or none at all, they may be left open. In some cases, treatment may be recommended using structural heart intervention, where a closure device is deployed using minimally-invasive techniques.
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What Are The Causes Of Hole In The Heart
- Genetics:A child may be at a higher risk of septal defect if either parent has a congenital heart defect. However, it is quite rare for a family to have more than one child with a defect.
- The presence of other genetic disorders:Children with a hereditary disorder like Downs syndrome often also have a heart defect from birth.
- Smoking:Babies born to mothers who smoked during pregnancy are prone to various congenital heart defects like ASD and VSD.
Still, there are a lot of unknown factors contributing to the various causes of holes in the heart. Therefore, scientists and doctors are working tirelessly to discover and research the various causes of holes in the heart.
Less Pain And Less Chance Of Infection
As there is no need to break the breastbone for keyhole heart surgery, the pain is considerably less than that caused by traditional open heart surgery. Although you will still need to allow yourself time to recover, this is likely to only last a few days rather than months. Another of the minimally invasive heart surgery benefits is that there is little or no risk of bone infection, due to no bones being broken.
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Why Is This Important
The research team says one of their aims in this project was to empower patients. Parents said it helped to know they were not alone in facing complications, that clinical teams had seen the complications before and knew how to deal with them.
Over the course of the project, the researchers kept in close contact with the organisation that monitors the outcomes of childrens heart surgery, called the National Congenital Heart Diseases Audit , and with those responsible for designing specialist health services. These groups now use the same definitions when talking about the complications of childrens heart surgery, and hospitals across the UK now use the list when recording what happens to children after their surgery.
Cardiac Resynchronisation Therapy And Cardiac Resynchronisation Therapy Defibrillator Device
If you have heart failure, you may need a special type of device called cardiac resynchronisation therapy device. As well as treating heart arrhythmias, this device also synchronises your hearts chambers to contract and relax in a regular way, which improves the pumping action of your heart.
There is also a type of CRT that can be used as above and in addition can deliver a shock to treat dangerous heart arrhythmias and then synchronise your hearts chambers to normal rhythm once more. This is CRT-D .
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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.
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.
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What Are Holes In The Heart
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.
Number Of Us Children And Adults Living With Chds
- Currently, there are a number of state-based birth defects programs that track CHDs among newborns and young children, but no tracking system exists to look at the growing population of older children and adults with heart defects.
- To date, other methods have been used to estimate the total number of children and adults with these defects. For example, one study estimated that, in 2010, over 2 million infants, children, adolescents, and adults were living with CHDs in the United States. Researchers estimated that about 1 million U.S. children and about 1.4 million U.S. adults were living with CHDs. Overall, there are slightly more adults living with CHDs than children. To obtain this estimate, researchers used data from administrative healthcare databases in Canada to estimate the prevalence of people living with CHDs and applied this to the U.S. Census data from 2010.
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Heart Surgery Survival Rates By Type Of Procedure
The Cardiac Center team performs more than 850 pediatric heart surgeries a year, including open heart and closed heart procedures and heart transplants. Open heart procedures, which represent a major portion of our volume, require cardiopulmonary bypass and are usually the most complicated and complex procedures.
Pediatric heart surgery survival rates reflect the number of patients who survived within 30 days of the surgery or until the time they were discharged, whichever period is longer.
We track outcomes from common procedures as Quality Indicators for congenital heart surgery. The following data shows CHOP’s outcomes for these procedures.
The cardiac surgery indicators are included in the Society of Thoracic Surgeons Congenital Heart Surgery Database and in the National Quality Forum standards for pediatric heart surgery. The STS Congenital Heart Surgery Database contains data from over 100 congenital heart surgery centers in North America. The NQF is a nonprofit organization that sets or endorses standards to measure quality in healthcare.
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, MitraClipÂ® placement for mitral valve abnormalities, and WATCHMANÂ® placement for nonvalvular atrial fibrillation patients.
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What Happens During Ventricular Septal Defect Surgery For A Child
Talk with your childs healthcare provider about what to expect during the surgery. In general:
- Your child will be given anesthesia before the surgery starts. Its usually done through an IV. Your child will sleep deeply and painlessly during the operation. He or she wont remember it afterward.
- The repair will take several hours.
- The surgeon makes a cut down the middle of the chest. He or she will separate the breastbone to reach the heart.
- Your child will be attached to a heart-lung machine. This machine will act as your childs heart and lungs during the procedure.
- The surgeon usually reaches the wall between the septum by looking through one of the valves of the heart. The surgeon closes the hole in the ventricle with a tightly woven patch material.
- Once the procedure has been completed, the heart-lung machine will be removed.
- Your childs breastbone will be put back together with wires.
- The surgeon will close the muscle and the skin. A bandage will be applied.
A Stroke With An Unknown Cause
Most people who have a PFO do nothave any symptoms. It may cause worry, though, if someone has a stroke withoutany clear cause.
If a stroke cant be attributed to acommon cause , that means its possible that the PFOallowed a blood clot to travel through to the brain.
If there is no communication between the two sides of the heart, the blood clot would have gone to the lungs, Dr. Reed explains.
Most small blood clots that go tothe lungs cause no symptoms. However, if they are large enough, they couldcause a pulmonary embolism, which is more serious but can usually be treatedwith medications.
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Coronary Angioplasty And Stenting
Coronary angioplasty and stenting is used to open up narrowed or blocked arteries which supply your heart muscle. This treatment is done to provide relief from symptoms of angina.
During angioplasty and stenting, the narrowed artery is stretched open with a balloon , and a metal strut known as a stent is implanted into the coronary artery. This keeps the narrowing open and allows your blood to flow more freely through it.
Angioplasy is also known as Percutaneous Coronary Intervention .
Heart Surgery In Young Children: Routine Monitoring Of Complications Can Help Assess The Quality Of Care
This is a plain English summary of an original research article
The vast majority of young children undergoing heart surgery survive the procedure the survival rate is 98%. This means that the current practice of monitoring survival alone is a blunt measure that does not give a full picture of childrens recovery. New research suggests that complications may be a better indicator of the quality of surgery and related medical care. Complications that affect the whole child and their quality of life, may be particularly informative.
The researchers worked with families and medical staff to compile a list of the nine most important complications of childrens heart surgery . They also looked at how common each complication was, and the impact it had, to assess how useful the agreed list was.
Parents and clinicians had overlapping but sometimes different views about which complications had the most impact. Clinicians prioritised problems related to the heart while parents were particularly concerned about complications that caused developmental problems. So the researchers developed a test to assess which children might go on to have developmental problems after surgery and need help catching up.
This work helps empower families as it focuses on the complications important to them. Data is now being routinely collected for seven of the nine complications identified in this study.
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Structural Heart Center At Georgia Heart Institute
When there are conditions affecting the structure of the heart, like PFO or ASD, its essential to receive highly-specialized care that starts with a precise diagnosis and innovative treatment options. Did you know that the Georgia Heart Institute of NGMC has a specialized program devoted to heart valve disease and congenital heart defects? Our team offers unparalleled expertise and unique care options for those who issues with the structure of their heart. Contact our Structural Heart Center at 770-219-5242 or learn more below!
How Does Sts Define Surgical Mortality
STS defines surgical mortality as the percentage of heart surgery patients who pass away during their operation or, if they have been discharged, within 30 days of their surgery. Mortality also includes the patients who are not discharged within 30 days but pass away during their hospitalization.
These STS definitions ensure that institutions across the country are using consistent data reporting methods.
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What Should I Expect After Surgery
Youll have follow-up visits with your doctor as you recover from catheterization or surgery. He or she may repeat an echocardiogram at these visits.
For 6 months after surgery or catheterization, ASD patients need to take antibiotics before a visit to the dentist or if they need certain other kinds of surgery, such as tonsil removal. This is to prevent bacteria from getting into the bloodstream and causing infective endocarditis , an infection of the inner surface of the heart. When the heart tissue has healed over the closed ASD, most patients no longer need to worry about the risk of infective endocarditis.
After their ASD is closed and theyve had plenty of time to heal, most teens have no further symptoms or problems.