Paediatric and Adult Congenital Heart Surgery
2 Doctors
Please wait while we prepare everything...
Please wait while we prepare everything...
The mission of pediatric and congenital heart surgery department is to continuously improve the outcomes and provide the best quality care to children born with heart defects. The department offers services covering the entire spectrum of congenital heart defects.
The department provides quality care for the entire spectrum of paediatric and congenital heart surgery at competitive cost. Our surgeons have performed more than seven thousand surgeries for congenital heart defects. Our centre is one of few centres performing surgical treatment of cardiac rhythm disorders.
Humane counselling to patients and their families with congenital heart defects. We consider them as part of our family and our care extends beyond discharge from hospital.
Babies born with critical cardiac defects will need life saving surgeries either immediately after birth or within the first month of life. We at Amrita Hospital provides following surgeries for these critically sick neonates.
We at Amrita hospital provide complex root translocation surgeries to patients. These procedures can convert single ventricle pathways to biventricular pathways with potentially superior longterm survival.
A sizeable number of children born with congenital heart defects will reach adulthood even without surgery. A even larger group of children who underwent surgery/intervention for CHD in childhood will need re-operations in their adolescence or adulthood for recurrent, residual or acquired heart defects. Our team of adult and congenital heart defects is fully equipped to take care of this ever-growing group of patients.
We need two ventricles for a sustaining life and longevity. However, a large number of children are born with either anatomical or functional single ventricle. Most of these children will need surgery in three stages to improve the quality and quantum of their lives. At Amrita Hospital we provide the following operations for babies born with single ventricles
It is ideal to repair rather than replace valves in children due to lack of growth potential implanted valves. Our team specialises in the following valve repair surgeries
A normal rate and rhythm of the heart is essential to provide adequate cardiac output to sustain life. Ant disturbance in the rate and rhythm are called arrhythmia. The arrhythmia can either be congenital or acquired. At Amrita Hospital we provide the following services for arrhythmia.
Vascular rings are birth defects where the airways are abnormally surrounded and/or compressed by the blood vessels. The child may have symptoms of wheezing, noisy breathing (stridor), intractable coughing, breathlessness, difficulty in feeding or swallowing, and respiratory infections. We at Amrita hospital offer following services for the diagnosis and treatment of these lesions.
Persistent pulmonary hypertension is debilitating and life limiting disease with very little treatment options. We offer a palliative reverse Pott’s shunt to selective group of patients with PPHN. A communication is created between the pulmonary artery and aorta to decompress an eminently failing right ventricle. This procedure improves the quality of life and potentially increase the lifespan without lung transplant.
Dilated cardiomyopathy is a progressive and debilitating disease which either leads to early demise or cardiac transplant. A specific group of these children are offered Pulmonary artery band to remodel the heart. This procedure leads to improvement in cardiac function and avoid the need of heart transplant is a large group of these patients.
An abnormal tissue growth in the chambers of heart, over valve leaflets or within the blood vessels can not only compromise with the heart function but also can be life threatening. We at Amrita hospital, offer surgery for Fibroma, Myxoma, Hemangioma, Intra-pericardial teratoma, lipoma and metastatic tumours which have spread to heart from other parts of the body.
Fellowship Program
Any abnormality in the heart present at the time of birth is called as congenital heart defect. One child in 100 will be born with some form of congenital heart defect. These can involve any of the four chambers of the heart, any of the four valves of the heart or any of the tubes connected to the heart. Children may have more than one defect in their heart.
The definitive cause of congenital heart defect is known only in a small number of children. An interaction between genes and environment is responsible for birth defects. Some of the causes for congenital heart defects are air pollution, maternal diabetes, maternal smoking, alcohol consumption by mother, older age of mother. Nutritional deficiency and viral infections like rubella, influenza ect during pregnancy can also cause congenital defects.
The incidence of congenital heart defect in normal population is approximately 1%. This means the one child out of 100 will have a heart defect at birth. But if your first child has a heart defect, the chances that your second child will have a defect too, will increase by 5%.
Yes, upto 90% of the birth defects in the heart can be diagnosed by an ultrasound examination as early as 18 to 20 weeks of pregnancy. Antenatal defects can be detected during early months of pregnancy and decision to terminate very complex defects can be made.
Birth defects can not be always be prevented with certainty. But one can avoid marriage with relatives, avoid pregnancy when “very young” and “old”, avoid smoking and alcohol consumption, avoid harmful drugs in first trimester, Vaccinate against Rubella and take Good nutrition during puberty and pregnancy to reduce the risk of congenital heart defects.
Most congenital heart defects will have certain signs and symptoms which will help in diagnosis. Some of these are blue nails and lips, fast breathing, poor feeding, poor weight gain, excessive sweating, raised chest, and repeated cough, cold or pneumonia. Older children may complain of breathlessness, tiredness, swelling of feet, light-headedness, chest pain and even loss of consciousness.
Not every child with heart defect will need surgery. In fact, a large number of children can be treated medically and some of these can be treated in the catheter lab without surgery. However, most complex heart defects will need surgery.
Many of children with congenital heart defects will need only one surgery. However, a large number of children will need more than one surgery. Most of these children will need regular follow-up.
The outcomes of surgery for most congenital heart defects are excellent and 98% of children undergoing heart surgery will survive.
Once the child has made recovery, he/she is discharged from the hospital. Detailed care instructions are given to the family at the time of discharge.
Their Child’s peri-operative period is perhaps the most stressful period in a parent’s life. This guide has been designed to help parents prepare for their child’s discharge from the hospital after cardiac surgery. Many families find that learning and talking about what to expect before their child goes home can help decrease anxiety and promote speedy recovery.
Incision Care:
When to call the doctor?
Your child is discharged from the hospital only after the medical team is satisfied with the child’s condition and is confident that child does not need hospital care. Nevertheless, your child may get unwell after discharge and may need medical attention. Please watch out for following signs and symptoms which may indicate that the child is unwell:
Feeding and Nutrition
Your child’s appetite may be poor when he/she first returns home, but it will improve with time. Please offer small frequent meals.
Nutritional advice for Infants and toddlers:
Home made instant formula feeds: This is a viable and cheaper alternative to commercially available formula feeds. It is easy to prepare. Please take 600gm of cereal/millet (Wheat/Rice/Ragi/Bajara/Jawar), 300 gram of pulses (Moong/Chana/Arhar) and 100 gram of Groundnut or white sesame seeds (Til) to prepare 1000gm of formula feed. These are roasted and ground separately and then mixed and stored in airtight container. Instant feed can be prepared by mixing two spoons of this mixture with boiled water or milk. Ghee and jaggary/sugar is added to improve the caloric value. Green leafy vegetables like spinach (Palak), Methi, Coriander can also be added.
Nutritional advice for older children:
Any special diets will be discussed with you before discharge. Occasionally, you may be asked to restrict your child’d daily fluid intake or you may be asked to give only fat-free diet to your child.
Medications:
Your child will invariably be prescribed medications at the time of discharge. Please ensure that you have understood the dosages correctly.
Activity Instructions for Children:
Your child may be tired for a couple of weeks after the operation and may need to rest during the day. However, your child should want to get out of bed for play every day. Notify the doctor if your child is lethargic and does not want to get out of bed.
How should I hold my child?
When to resume School/Work ?
Coughing and Deep Breathing:
Emotional Behavior:
As a result of this hospitalisation and surgery, your child may act like he/she did when younger. This can be normal and can be due to stress.
Immunisations:
Your child is at an increased risk of developing infective endocarditis (Infection of the inner lining of the heart chambers)
Follow-up Appointments:
Your child is vulnerable and at high risk of developing infections in the post-operative period. It is of utmost importance that basic hygiene is maintained and a clean environment at home is provided.
Oral hygiene and dental care
Good oral hygiene is of paramount importance as children with poor dental hygiene are at higher risk of developing infective endocarditis (Infection of the inner lining of Heart chambers)
Frequent loose motions for more than 48 hours invariably cause diaper rash. It can be very painful leading to excessive crying and irritability.
Excessive crying/irritability
Crying is a way of communication for infants. Most infants will cry for one to three hours daily. However, if the child is crying excessively beyond this period, a cause has to be found and treated. Generally, the surgical site is not painful after 5 to 7 days of surgery. An inconsolable child can be very distressing to the parents. The common caused of excessive crying are the following:
Check your child’s temperature and diaper for soakage. Hold the child close to your chest; cuddle him/her and initiate feeds. Invariably the child will stop crying with these measures. If the child is still inconsolable beyond 24 hours please visit your doctor.
Home made oral rehydration solution (ORS)
Your child may have been prescribed certain medications like warfarin/Acitrom which will increase the tendency to bleed. If your child is taking warfarin or Acitrom following precautions must be followed:-
If your child has undergone surgeries which will culminate into Fontan physiology, your child will have reduced exercise capacity. It is also absolutely necessary that their lung health is optimal. Following measures are advised to increase exercise capacity and maintain good lung-health.
Your child may have one of the syndromes associated with heart defects which will reduce the ability to fight infections. Heterotaxy syndrome and DiGeorge syndrome are two such examples.
ul.rich { list-style-type: square; }
Pacemaker is a device which sends and receives electrical signals to the heart and thereby control your child’d rate and rhythm. If your child has a pacemaker implanted following
Precautions should be followed:
Heart is one of the first organs to form in the foetus. An abnormal formation of the heart in the womb can lead to congenital heart defect. In most cases the factors causing this are not known. However, multiple genetic and environmental factors have been attributed. Some of these factors are as follows
*The incidence of a heart defect in subsequent offsprings is higher than normal population. This can be 3 to 80 times higher depending on the type of defect. Therefore it is imperative that fetal echocardiogram is performed in the second trimester between 18 to 24 weeks during subsequent pregnancy.
*The incidence of heart defect is higher if both parents are blood-relations. It is advisable to avoid marriages within the family.
*The incidence of heart defects is higher in the offsprings of parents with heart defects.
*The incidence of heart defects is higher in pregnancy from assisted reproductive technology.