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Out of 1,000 newborns, 7-8 children are affected by a congenital anomaly of the heart or large arteries, although these abnormalities are not so severe that they require surgery. With an annual number of approximately 700,000 newborns in Germany, we therefore have to expect about 5,000 new patients per year. Due to major advances in diagnostics, operative therapy and postoperative care of children with congenital heart problems, about 85% of patients today reach adulthood.
Pediatric heart surgery includes all treatment forms of serious congenital heart defects. Before any surgical intervention on a child’s heart, the all-embracing diagnostics is inevitable. The German clinics offer the following diagnostic procedure for children.
- Laboratory tests (such as complete blood examination, urine tests, electrolytes, clotting factors etc.
- X-rays examination
- EKG, or ECG
- Cardiac catheterization
Ventricular septal defect
Infants and children very often have so-called ventricular septal defect (VSD). These defects can be much or less complicated, they also can lead to blood mix at atrium or at the cardiac ventricles. The blood mix is mentioned because rich oxygen blood transfer from lungs migrates to the right ventricle due to this defect (an opening) in the interseptum between the right and the left heart ventricles. When blood is located in the right ventricle, it gets mixed with oxygen-deficient blood. Defect proportion influences a degree of appearing symptoms severity. In a case of even more complicated defects including big ventricular septum openings blood gets mixed which leads to mionectic oxygen supply. The symptoms are very apparent: skin color changes and low physical endurance. In such cases, heart surgery is a problem solution because with a help of surgery doctors close the opening. At the same time, smaller defects may remain unnoticed for years. Such heart disorders can be diagnosed by using ECG, heart cautery and with a help of other visualization methods.
Heart treatment in Germany
During the consultations with parents, a doctor identifies the optimal sequence of actions. Not every heart defect is a case of the pediatric heart surgery. Many small defects can be firstly regularly examined via echocardiography. A lot of openings located on the right and the left heart ventricles may be healed independently without any pediatric heart surgical intervention. In cases when this opening cannot be adhered, in most cases it doesn’t cause any problem because the risk of carrying out a surgery sometime later in childhood or teenage period is the same.
Ignoring a heart defect repair leads to really serious sequelae such as inflammation, arrhythmia, and aortic valves diseases and remediless lung changes.
The defect located in the interseptum between the right and the left ventricles is the most widespread heart disorder. A surgery proceeds accordingly to the regular flow and is known as low-risky.
Elimination of heart defects
The cardiac defect is eliminated by sewing in a patch into a ventricular septum. Any other similar defects can also be resolved through surgical treatment. Depending on defect’s location between two heart ventricles, there are different penetration methods into a heart in heart treatment. Penetration through a tricuspid valve is not the only effective approach; some alternative methods exist as well. The same surgery can be also conducted through left heart (pulmonic valve) and directly through a valve of a big aorta to the left ventricle. Very rarely, a rupture of the right heart ventricle is opened close to the edge of the operated organ.
After the surgical intervention is finished, a child who was operated on has big chances to live a normal life with a healthy heart. However, at the first outset of this recovery process, a regular visiting a doctor is obligatory.
Remediable heart defects, sparing techniques
Remediable heart defects are treated through a remediated surgery in the first year of life. Currently, depending on a heart defect type, such surgery can be carried out during the first 3 months of life. The surgery provides a child with normal psychological and physical development and, moreover prevents further complications, caused by complicated heart defect.
If a patient rejects the treatment, the probability of cardiac failure and weak heart muscle is high. If the worst comes to the worst, an artificial heart implantation is the only option. It may work out if a donor’s heart is found quickly.
This task to find a donor’s heart is not that easy as it may seem. That’s why early heart defect repair is the best option for a child’s further life. The most widespread treatment method in pediatric heart surgery involves heart valve surgery. Modern medicine can fix even the most complicated heart disorders in the long-term perspective using injured heart part reconstruction and autogenous tissues. That is why pediatric heart surgery of heart valves is much preferable than artificial valve replacement. Many clinics tend to reconstruct heart valves currently. As it was proved, it positively influences on heart function and quality of life.
Heart surgery in childhood is sometimes the only way to stay healthy. If you want to get more detailed information regarding modern surgeries in Germany, please, contact us via phone number on our website.