How are congenital heart defects treated?

Throughout the world about 20 percent of infants die due to congenital heart defects. In India, about 58 percent cases of new born babies especially between the ages of 0 to 5 years are with congenital heart disease.

Congenital heart defects:

Congenital heart defect is the major and very common type of birth defects seen in children. It is a condition which involves the structural defect of the heart during the time of the birth. Walls of the heart, valves of the heart and the arteries and veins located near the heart are involved in the defects. Due to this the normal flow of the blood is interrupted.  

Diagnostic procedures for congenital heart defects:

For the diagnosis of congenital heart defects, the doctors perform certain physical examination and some heart tests. The defects can be found during the pregnancy or soon after birth of the baby.

Physical examination:

Ø  Physical examination includes listening to the heart and lung of the baby by using stethoscope.

Ø  Check if the colour of the skin, nail and lips of the baby shows any blue coloured shade.

Ø  Shortness of breath or rapid breathing is common.

Ø  Delay in growth is a hallmark of congenital heart disease.

Diagnostic tests:

Ø  Echocardiography

Ø  EKG (Electrocardiogram)

Ø  Chest X Ray

Ø  Pulse Oximetry

Ø  Cardiac Catheterization

Treatment for congenital heart defects:

Many children do not require treatment for congenital heart defects, but in severe conditions the treatment is a must.

Different factors for providing an appropriate treatment:

Treatment differs from one child to another child, it completely depends upon the following:

·         Severity of the condition

·         Age

·         Weight

·         Height

·         General health condition

The doctors treat the patients by providing a combination of surgical procedures. In case of severe heart defect, the doctor may perform several catheter or surgical procedure during the first year of life. Some children are recommended to take medications for long term.

Treatment involving catheter procedure:

Catheter procedure is easier than that of a surgery. This procedure involves the insertion of catheter into the vein or an artery. This procedure doesn’t involve opening of heart for treating the defects. Since past 20 years, the use of this procedure has been increasing. Some heart defects like atrialseptal defect (ASD) and pulmonary valve stenosis can be treated easily by using this method.

In the treatment of atrial septal defect (ASD), the doctor places the catheter attached with a small device in the vein near the area of upper thigh. The tube runs along the way towards the heart septum. The device gets pushed out of catheter once the catheter reaches the septum. When the device is secured in the place, the catheter is taken out from the body. The normal tissue grows within 6 months and the device doesn’t need to be replaced.

Surgical treatment:

When the heart defects cannot be fixed by using a catheter, then the doctors opt for a surgery. It is an open-heart surgery, which fixes the defect completely. If the defects are not fixed completely, then repeated surgeries are performed.

The surgery might be done for the following reasons:

·         Close the hole present in the heart

·         Restore or change the heart valve

·         Enlarge the arteries

·         Change the complex defects

Babies born with multiple defects undergo transplantation of heart, where the damaged heart is replaced with a new and healthy heart of the donor.

Way to live with congenital heart defect:

ü  Children with congenital heart defects are able to live a normal life. However, routine checkup is very important as they grow up.

ü  The child should comply to the prescribed medicines.

ü  Regular dental checkup helps the child to avoid the risk of infective endocarditis, because children with severe heart defects have a higher risk of developing infective endocarditis.

ü  Collect all the medical records and information of the child which includes diagnosis, underwent surgeries or procedures, medications, regular medical follow up recommendations, health insurance.

ü  Consult a dietician regarding the healthy nutrition of your child.

ü  Discuss about the emotional status of your child with their doctor.

ü  Women with any kind of heart defects should consult a doctor before pregnancy.

What Is Bariatric Surgery And It’s Types?

Bariatric surgery is a type of weight loss surgery that is achieved through the modification of the stomach with the help of a gastric band. It can also be done through the removal of a portion of the stomach or by re routing the small intestine to a small pouch. Bariatric surgery is performed on those patients suffering from obesity and other weight problems.

Long term studies depict a significant reduction in weight, recovery from diabetes and reduction in mortality rate of 23% to 40% after the procedure. There are different types of bariatric surgeries that can be performed according to each patient’s condition.  Here are the different  types of Bariatric Surgeries:
Gastric Bypass:

Often considered the gold standard of weight loss surgery, gastric bypass is also known as Roux-en-Y Gastric Bypass. The procedure involves creating a small pouch by dividing the top of the stomach from the rest of the stomach. After this, the first portion of the small intestine is halved, and the bottom end is brought up and connected to the newly created stomach pouch. The top portion of the divided small intestine is attached to the intestine so that the acids and digestive enzymes will eventually mix with the food for seamless digestion. This type of surgery results in long term weight loss and also helps in restricting the amount of food intake.
Sleeve Gastrectomy:

This bariatric surgery involves the removal of up to 80% of the stomach. It is also known as Laparoscopic Sleeve Gastrectomy. The stomach, post surgery, resembles a banana shape and is significantly smaller than the original. This results in the consumption of smaller portions of food items and, therefore, fewer calories. It also impacts gut hormones that curb hunger, satiety and blood sugar. This surgery has been proven to control type 2 diabetes as well. This is a non reversible procedure so patients must be absolutely sure of themselves before undergoing this surgery.
Adjustable Gastric Band:

The adjustable gastric band, often known simply as the band, is placed around the upper portion of the stomach creating a tiny pouch above the band and a large segment below the band. The idea behind the insertion of the band is to invoke a feeling of fullness by consuming smaller quantities of food. The position of the band can be adjusted at different points in time by filling the band with sterile saline, which is injected through a port placed under the skin. The biggest advantage to this surgery is that there is no cutting of the stomach and rerouting of intestines. However, patients who have undergone this surgery must be extremely careful post surgery as it requires a strict post operative diet and follow up visits to the doctor.
Biliopancreatic Diversion with Duodenal Switch (BPD/DS) Gastric Bypass:

Similar to the Sleeve Gastrectomy procedure, BPD/DS is a type of bariatric surgery where a smaller stomach pouch is created by removing a portion of the stomach. The first segment of the small intestine called duodenum, is divided into two parts. The latter portion of this is then brought up and attached to the newly created stomach. Thus, when food is consumed, it goes through the stomach and empties into the last portion of the small intestine. This helps reduce fat by around 70% and allows patients to eat normal meals after the surgery.

The above procedures all result in significant weight loss and improvement in quality of life for those suffering from obesity and other weight problems. There are certain risks and requirements for each procedure. But with a strict adherence to the doctor’s guidelines and an experienced medical team, any complications are likely to be resolved successfully.