How dangerous is when a congenital heart defect is diagnosed, how many types of defects are there, how are they treated and what surgeries are performed?
Omar Gogia, pediatric cardiologist at the Jo Ann University Hospital talks about these and other issues.
Is it dangerous, when a diagnosis of congenital heart disease is put?
Parents often have questions about whether a congenital heart defect is dangerous; whether surgery is necessary, and when; whether the defect can be treated with drugs, and many other
questions.
Fortunately, the level and achievements of modern medicine give doctors the opportunity to say that this diagnosis is not dangerous and it is not a sentence for a child.
There are many types of malformations; some are simple and others are complex. Most of them require surgical intervention, although there are malformations that can be treated
without surgery, by, so called, an invasive method (catheterization). Very rarely, it is possible to only observe and use drugs (the so-called. drug therapy).
How is a heart defect diagnosed?
The primary method of diagnosis is an ultrasound examination of the heart – i.e. echo cardioscopy. It is preferable that this examination is performed in a prenatal stage. The
ultrasound examination is performed starting from the 18-th week of gestation. At this time, the heart is already formed and it is possible to reveal almost all defects.
Why is such an early diagnosis important?
This is important in order to plan the tactics of treatment of a newborn. There are malformations that require surgery when a newborn is 5-7 or 7-10 days old. If timely intervention is not performed, the risk and possibility of complications increases. In such a situation the newborn’s weight, gestational age and condition of other newborn’s organs play a decisive role. There are no restrictions in modern cardiac surgery. All listed above are only risk factors. In our practice, there were newborns weighing only 500 – 850 grams. Of course, in these cases we are talking about premature newborns.
The second stage is when the echo-cardioscopy of a newborn’s heart is performed, this gives us the opportunity to decide when and what kind of intervention is needed. At this time, a joint
decision by surgeons and cardiologists is made.
Always and in all cases, we choose the method that will be the least risky for a child. Of course, every intervention, be it surgical or invasive, has its own risk of complications. An accurate
diagnosis is basically a confirmation of the fetal diagnosis; accuracy of a diagnosis permits us to select what kind of intervention should be performed. Our patient may be days, months or
years old. As I have mentioned above, there are defects that require intervention when a patient is only several days old; as a rule they are conditions associated with cyanosis (bluish
color). Of course, there are defects not associated with cyanosis; though in mentioned above defects, a patient may have heart failure, or a condition when the heart cannot cope with the
load and perform its function – to supply blood to the whole body. In such cases, some malformations require intervention within days, while others endure several weeks or months
In case, when an operation is planned to be performed in several months, the patient receives drug therapy to prepare him/her for a surgery. At this time, it is absolutely necessary to have
constant communication between parents and cardiologists. Parents should continuously observe their child so as not to miss any details and promptly inform a cardiologist if any
changes in the child’s condition occur.
Besides providing parents with full information about a malformation and their child’condition, we always encourage them to learn as much as possible about the pathology, for
example, searching information in the Internet. Today there are a lot of sources of necessary and correct information, though, unfortunately, some sources provide fake information; thus, it
is necessary to analyze everything you find.
Parents often ask how many operations their child may need, and what life will he/she have after being operated…
The complexity/severity of the defect determines how many operations should be performed. There are malformations when only one intervention is needed, although some defects need more than one operation. No matter how many operations a child undergoes, he/she will lead absolutely unlimited life, concerning his/her growth, development, going to kindergarten or school, studying, socializing with friends, and even sports. All our work is aimed at improving the quality of their lives. Relationship between doctors and parents at each stage are very important, no matter how many operations the child needs, whether it is one or more, this is the way we must go through together.
Heart defect, Omar Gogia
