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Pediatric heart surgery in India by specialized cardiac surgeons - Video

Pediatric heart surgery in India is performed by specialized cardiac surgeons who are known internationally for their medical expertise. The level of education and expertise of the cardiac surgeons and medical staff in India is very high and their extra ordinary performance has become a daily routine for them. As a result, their expertise and capabilities are frequently sought after on a world-wide scale. Significant efforts in quality management, accreditations and national and international benchmarking are employed to maintain and even further improve quality of care in India. Exceptionally short waiting time for surgeon’s consultations, short waiting lists for surgeries, direct access to surgeon’s and the outstanding medical results has pushed India into the top position for pediatric heart surgery.

Pediatric heart surgery often deals with cases of congenital heart disease. Congenital heart disease is a common heart ailment among new born children and involves deficiencies like structural defects, congenital arrythmias and cardiomyopathies. This leads to different kinds of abnormalities related to the heart. Congenital heart disease is a cause of improper growth of the heart or blood vessels before birth. Pediatric heart surgery deals with operative procedures dealing with newborn and unborn children and youngsters suffering from cardiac dysfunctions. Structural, functional and rhythm-related issues of the heart are dealt with by the Pediatric Cardiology department of Apollo hospitals.

Types of pediatric heart surgery

• Coronary artery bypass graft
• Heart valve procedures
• Septal myomectomy
• Norwood procedure
• Arterial switch operation
• Rastelli procedure

Procedure – In this video, before the pediatric heart surgery begins after the patient is asleep, a device called the swan-ganz catheter is often inserted into the jugular vein and threaded to the pulmonary artery. The catheter is used to measure heart function and heart and lung pressure. It can also be used to give medication and measure the oxygen levels in the blood. A breathing tube will also be inserted into the mouth and down the windpipe to maintain an airway. A urinary catheter is also inserted and connected to a collection bag to measure the patient’s urine output. In the pediatric heart surgery an 11- to 12-inch incision is made in the chest and the breastbone is split in two. A retractor is then used to pull back the breastbone and ribs in order to open up the chest. The functions of the heart, including blood flow and oxygenation, are rerouted through a heart-lung machine, so that the heart can be safely stopped during the procedure by the injection of a cooled cardioplegia solution.

The pediatric heart surgery begins, according to what the particular condition requires:

• Coronary artery bypass graft – This type of pediatric heart surgery is used to treat coronary artery disease. During CABG, a surgeon takes a segment of a healthy blood vessel (either an artery or vein) from another part of the body, and uses it to create a detour or bypass around the blocked portion of the coronary artery. As a result, oxygen-rich blood can flow more freely to nourish the heart muscle. The bypasses required by the patient depend on how many coronary arteries are blocked. Other procedures may be combined with this surgery.
• Heart valve procedures - This type of pediatric heart surgery is used to repair or replace a defective valve. Defective valves that cannot be repaired are replaced with either a biological or a mechanical valve. Another type of open-heart valve procedure is a valvotomy where the surgeon cuts into a valve to repair damage.
• Septal myomectomy - This type of pediatric heart surgery is used to treat hypertrophic obstructive cardiomyopathy, an inherited heart condition characterized by an abnormal growth of muscle fibers of their heart. During the procedure, a surgeon removes part of an enlarged septum, which is the muscular wall between the left and right ventricles of the heart.
• Norwood procedure – In this type of pediatric heart surgery the patient has to undergo a series of surgeries to treat hypoplastic left heart syndrome, in which the chambers, valves and related blood vessels on the left side of the heart are so malformed that they cannot efficiently pump blood to the rest of the body. The first two surgeries are used to temporarily relieve blood flow problems to and from the lungs. The third surgery, known as the fontan procedure, is used to further improve the circulation but cannot cure the underlying heart defects.
• Arterial switch operation – This type of pediatric heart surgery is used to treat transposition of the great arteries, in which the aorta and the pulmonary artery are in reversed locations, resulting in oxygen-rich blood from the lungs not being able to get to the brain and the rest of the body. During the procedure, the pulmonary artery is disconnected from the pulmonic valve, which arises from the left ventricle. The aorta is disconnected from the aortic valve, which arises from the right ventricle. The aorta is then connected to the pulmonic valve, so that it is exiting from the left ventricle, as it should. The pulmonic valve is connected to the aortic valve, so that it is exiting from the right ventricle, as it should.
• Rastelli procedure – This type of pediatric heart surgery is used to treat a cyanotic heart defects that restrict the normal flow of blood from the heart to the lungs. The Rastelli procedure is used when a hole in the heart is involved in the defect. The hole is patched to redirect blood flow. Some of these defects include: transposition of the great arteries with ventricular septal defect, pulmonary stenosis, pulmonary atresia with VSD and double outlet right ventricle with pulmonary stenosis.

Recovery post pediatric heart surgery

• The patient is required to keep the incision clean and dry.
• The patient should use only soap and water to cleanse the area.
• The patient should eat a healthy diet to help healing.

Standards of treatment and care in India’s private medical clinics are exceptionally high. The visitors coming to India for pediatric heart surgery are presented with a professional package of skilled specialists and dedicated nursing and administration staff, along with high grade equipment and pharmaceutical products. The Indian cardiac surgeons performing pediatric heart surgery are invariably from the finest educational backgrounds and have extensive experience in the industry.

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