How advanced procedure gives hope to babies with congenital heart disease?

In India, eight out of every 1000 newborn babies suffer from heart defects which makes the country the leading nation in premature deaths. These defects range from simple to complex. Certain problems can be examined by the doctor and managed with medicines, others require surgery, at times in the first few hours of the child’s birth.

By Dr. Dinesh Bisht

An infant’s heart starts to develop during the first eight weeks of pregnancy, and this is also the time when congenital heart defects occur. Mothers often wonder if they did something during the pregnancy that caused the defect. However, in most cases no specific cause can be found and there may be a genetic link, or the mother had a disease while she was pregnant and was taking medicines. As the world is battling COVID-19, on this World Heart Day it becomes even more critical to spread awareness around cardiovascular diseases and advanced treatments to manage them. In India, eight out of every 1000 newborn babies suffer from heart defects which makes the country the leading nation in premature deaths. These defects range from simple to complex. Certain problems can be examined by the doctor and managed with medicines, others require surgery, at times in the first few hours of the child’s birth. In some cases, the baby may ‘grow out’ of the simple heart problem. For instance, atrial septal defects close on their own as the infant grows.

It is critical to know how the heart works to understand congenital heart disease. The heart is divided into chambers – two upper chambers (atria) and two lower chambers (ventricles). The right side of the heart transfers blood to the lungs through blood vessels or pulmonary arteries. Oxygen rich blood in the lungs then returns to the left side of the heart from lungs. The left side of the heart then pumps blood to the rest of the body. When an individual suffers from congenital heart disease, any of their heart structure can get affected including valves, chambers, arteries, and the wall of tissue that separates the chambers called septum.

Congenital heart defects can be classified into several categories including Patent ductus arteriosus (PDA), Atrial septal defect (ASD), Ventricular septal defect (VSD), Atrioventricular canal (AVC or AV canal), Tricuspid atresia, Coarctation of the aorta (CoA), and Aortic stenosis (AS).

Some of the congenital heart problems such as PDA, ASD and VSD cause too much blood to pass through the lungs. PDA occurs when a blood vessel called the ductus arteriosus that connects the pulmonary artery directly to the aorta and is supposed close after birth, remains open. This leads to extra blood flow from aorta to lungs and is often seen in premature infants. These children experience rapid breathing and poor weight gain.

Atrial septal defect (ASD) occurs due to a hole in between the two upper chambers of the heart. This causes an abnormal blood flow through the heart. Some children with ASD may appear healthy with no symptoms, however, if the hole is too large it will permit more amount of blood to pass to the right side and symptoms will be apparent.

Ventricular septal defect (VSD) occurs when there is a hole in the dividing wall between the two lower chambers of the heart. Due to this condition, extra volume of blood is pumped into the lungs by the right ventricle which creates a congestion in the lungs.

Congenital heart defects are detected during pregnancy using an ultrasound (Foetal echocardiography or anomaly scan). After birth, the defects are diagnosed when on physical examination, the doctor finds abnormal pulses or abnormal heart sounds, low oxygen levels, and other heart-related abnormalities in the infant.

Which Specialists to Consult for Congenital Heart Defects?

We often confuse which specialist to visit when we observe abnormalities such as a blue tinge to the skin or lips, rapid breathing, and heartbeat, swelling the legs, stomach and around the eyes, shortness of breath during feeding, extreme tiredness, and fatigue, swelling in the hands, ankles, or feet in the infant. Babies with such defects are treated by specialists called paediatric cardiologists. These doctors diagnose heart defects and help parents to manage the health of children before and after surgical repair of the heart problem. Specialists who correct these problems in the operating room are known as paediatric cardiovascular, or cardiothoracic surgeons.

For years, congenital heart defects were repaired with open-heart surgeries that included risks like blood transfusion, blood infections and longer hospital stay. Credit it to advanced technologies, we now have minimally invasive procedures to treat infants with less complications and shorted hospital stays.

How Technology can Save Babies with Hole in the Heart

Thanks to continuous innovation in the field of medical technologies. Significant improvements have been seen in modality that corrects many of these heart diseases without surgery. For example, a patient suffering from PDA can now be diagnosed, treated, and assured a risk-free life going beyond the risk of an open-heart surgery. Such patients can now be operated in a minimally invasive corrective procedure. The first step to identifying heart defects is to screen a patient through echocardiography, a diagnostic procedure. Upon identifying the defects and the severity of the condition, a doctor will suggest appropriate prognosis. The new-age devices such as occluder’s (a device that blocks a hole in the wall of a heart) are promising solutions to babies with CHDs in a non-risk environment. The device is used on children above 6 months mostly, however, miniaturized version of it is used to close a hole in the heart of an infant or premature baby weighing as little as 700 grams.

By Dr. Dinesh Bisht, Pediatric Cardiologist, IGMC (Indira Gandhi Medical College), Shimla

(DISCLAIMER: The views expressed are solely of the author and ETHealthworld.com does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person/organisation directly or indirectly.)

Source : https://health.economictimes.indiatimes.com/news/industry/how-advanced-procedure-gives-hope-to-babies-with-congenital-heart-disease/86725146