Baby Heart » Babyheart

Patent Ductus Arteriosus (PDA) Surgery

maitri — Fri, 15 Jul 2011 08:31:33 +0000

PDA refers to an open vessel that allows blood to flow between the aorta and the pulmonary artery. The ductus arteriosus is open during fetal life to divert blood away from the unused lungs. Normally the ductus closes within the first day of life, but for unknown reasons it sometimes remains open. This occurrence is more common in premature infants. If the PDA is small, there may be no symptoms at all. Symptoms of a large PDA are rapid breathing, fatigue, and slow weight gain. After surgical correction, these symptoms will disappear. The surgery involves a left thoracotomy incision. The vessel is “ligated” and divided in half or clipped so that there will be no flow. This is a curative operation; no other surgery is required.

WHEN IS PDA LIGATED?

Usually PDA is closed without surgery by device closure. There are only 3 scenarios where PDA is operated:

1.Premature babies with large PDA and developing heart failure

2. PDA with infective endocarditis

3. Large PDA in babies <5kg causing recurrent chest infections or poor weight gain

Author: Dr Bhasker Semitha

Pediatric Cardiothoracic Surgeon

Closed Heart Surgery

maitri — Fri, 15 Jul 2011 08:31:07 +0000

Closed heart surgery implies that the “heart lung machine” or “bypass” machine is not used and the heart is visualized but not cut open. Listed below are details of three types of closed heart surgery:

Closed Heart Surgery

High Muscular VSD in a 4 year old boy

maitri — Sun, 30 Jan 2011 15:45:33 +0000

The video shows a VSD which is the most common type of hole in the heart. This location of VSD allowed us to do a nonsurgical closure of the hole by device. Though this is technically difficult, this allows the child to have complete one time cure of the hole without any scar
Continue to video

CARDIOPULMONARY BYPASS

maitri — Wed, 19 Jan 2011 08:30:41 +0000

A heart-lung machine (also called cardiopulmonary bypass) is usually used during open heart surgery. While the surgeon works on the heart, the machine helps provide oxygen-rich blood to the brain and other vital organs.

Author: Dr Bhasker Semitha

Pediatric Cardiothoracic Surgeon

HEART AS SEEN BY CARDIAC SURGEON

maitri — Wed, 19 Jan 2011 08:30:03 +0000

Author: Dr Bhasker Semitha

Pediatric Cardiothoracic Surgeon

HOW THE CHEST IS OPENED DURING CARDIAC SURGERY?

maitri — Wed, 19 Jan 2011 08:28:52 +0000

The heart surgeon will make a 2-inch to 5-inch-long surgical cut in the chest wall. Muscles in the area will be divided so the surgeon can reach the heart. The surgeon can repair or replace a valve or perform bypass surgery.
During endoscopic surgery, the surgeon makes one to four small holes in the chest. Then he uses special instruments and a camera to perform the surgery.
During robot-assisted valve surgery, the surgeon makes two to four tiny cuts (about 1/2 inch to 3/4 inch) in the chest. The surgeon uses a special computer to control robotic arms during the surgery. The surgeon sees a three-dimensional view of the surgery on the computer. This method is very precise.

Author: Dr Bhasker Semitha

Pediatric Cardiothoracic Surgeon

www.babyheart.in

Open Heart Surgery

maitri — Wed, 19 Jan 2011 08:28:25 +0000

Open heart surgery is any surgery where the chest is opened and surgery is performed on the heart muscle, valves, arteries, or other heart structures (such as the aorta). The term “open” means that the chest is “cut” open .

Most heart surgery is performed under general anesthesia, requiring that the patient be intubated and put on a ventilator(artificial breathing machine). Some less invasive procedures, such as placing stents or a pacemaker, may be performed with monitored anesthesia care, known as twilight sleep.

Author: Dr Bhasker Semitha

Pediatric Cardiothoracic Surgeon

www.babyheart.in

Cardiac Surgery in Children- A Detailed Glossary

maitri — Wed, 19 Jan 2011 08:27:43 +0000

Type	Procedure	Defects Treated	Description
Shunts	Blalock-Taussig	Reduced pulmonary blood flow (TOF, TGA, pulmonary atresia, tricuspid atresia)	Classic: Anastomosis of subclavian artery to PA (with or without modification)
Atrial mixing	Surgical atrial septostomy	TGA (early palliation), mitral atresia, complex congenital heart disease	Also called Blalock-Hanlon procedure
	Balloon atrial septostomy	TGA, tricuspid atresia	Percutaneous atrial septostomy, also called Rashkind balloon procedure
Closures	Atrial septal defect (ASD) closure	ASD with significant shunt	Primary or patch closure
Closures	Atrial septal defect (ASD) closure	ASD with significant shunt	Percutaneous closure
	Ventricular septal defect (VSD) closure	Isolated VSD or with other anomalies (TOF)	Primary or patch closure
	Patent ductus arteriosus (PDA) ligation	Patent ductus arteriosus	Ligation ± division of PDA
	Patent ductus arteriosus (PDA) ligation	Patent ductus arteriosus	Transcatheter technique
	Endocardial cushion defect repair	Endocardial cushion defect (also called atrioventricular canal defect)	Closure of ASD and VSD, repair of atrioventricular valve abnormalities (e.g., cleft mitral leaflet)
PA banding	Surgical reduction in flow area of PA	Large left-to-right shunt lesions	PA band to decrease PA flow and pressure
Atrial baffles	Mustard	TGA (replaced by arterial switch procedures at many centers)	Dacron or pericardial baffle directs systemic venous return to PA via anatomic LV, pulmonary venous return to aorta via anatomic RV
	Senning	TGA (replaced by arterial switch procedures at many centers). May be used as part of “double switch” procedure for L-TGA	RA free wall and interatrial septal tissue used for interatrial baffle similar to a Mustard repair.
Relief of stenosis	Aortic coarctation repair	Aortic coarctation	Various procedures including end-to-end anastomosis, patch enlargement, Gore-Tex graft; balloon dilation for recoarctation
Relief of stenosis	Aortic coarctation repair	Aortic coarctation
	Pulmonic valvotomy	TOF, pulmonic stenosis	Brock trans-RV approach
			Direct surgical repair
			Balloon dilation
	Aortic valvotomy	Congenital aortic stenosis	Direct surgical valvotomy or percutaneous balloon dilation
	Mitral repair	Congenital mitral stenosis	Surgical commissurotomy—initially a “closed” procedure without cardiopulmonary
	Mitral repair	Congenital mitral stenosis

Types of Heart Surgeries in Children

maitri — Wed, 19 Jan 2011 08:27:13 +0000

The common procedures which are performed on the heart can be grouped into several categories :

– Hole Closures
-Shunts
-Relief of Stenosis
-PA Banding
-Atrial Baffles
-Conduits
-Relief of Cyanosis

Author: Dr Bhasker Semitha,
Pediatric Cardiothoracic Surgeon

WHAT IS CARDIAC SURGERY?

maitri — Wed, 19 Jan 2011 08:26:44 +0000

Cardiac surgery is a surgery on the heart and/or great vessels performed by a cardiac surgeon. Heart surgery is done for a variety of reasons and ranges from minimally invasive procedures to actually removing the heart and replacing it with a donor heart. Frequently, it is done to treat complications of heart.