Congenital heart defect correction

Congenital heart defect correction treatment in Hebbal, Bangalore

A doctor may suspect a diagnosis of a congenital heart defect in a child after birth. Generally, growth delays or pale lips, tongue or fingernails are symptoms that a doctor will notice. The doctor could also hear a slight heart sound or murmur when listening to the heartbeat with a stethoscope. Most heart murmurs are not fatal, but some could cause changes to the blood flow to and from the heart.

Tests to diagnose a congenital heart defect

• Pulse oximetry- a sensor is placed on the fingertip to record the amount of oxygen in the blood. Too little oxygen is a sign of a heart problem.

• Electrocardiogram- The test, which monitors the heart's electrical activity and is non-invasive. The chest is covered with sticky patches with sensors, and cables are attached to the patches via the computer, which displays the results.

• Echocardiogram uses sound waves to create images of the heart in motion and shows how blood flows.

• Chest X-ray- It shows the condition of the heart and if it is enlarged.

• Cardiac Catheterization- A flexible, thin tube is inserted into the blood vessel and guided to the heart. 

• Magnetic Resonance Imaging- It creates 3D pictures of the heart to detect, diagnose and evaluate congenital heart defects. 

Treatment

Congenital heart defect correction treatment in Hebbal, Bangalore varies and depends on the severity of the heart problem. Sometimes the congenital heart defect may not have a long-term effect and could be left untreated. However, it could lead to problems right from birth or manifest when the person ages. Treatments for congenital heart defects include:

Medications

• Medications like blood pressure drugs ( beta blockers, angiotensin II receptor blockers, and angiotensin-converting enzymes), water pills (diuretics), and heart rhythm drugs ( anti-arrhymtics) could be administered to treat symptoms like irregular heartbeat, reduction in the amount of fluid that strains the heart.

Surgery and other procedures

• Cardiac catheterisation- A few congenital heart defects can be repaired using flexible, thin catheters without needing open-heart surgery. It could be used to fix holes in the heart or narrow areas. A catheter is inserted into the blood vessel from the groin, and tools are passed through the catheter to repair the defect.

• Open Heart Surgery- A minimal invasive or open-heart surgery may be needed to correct a congenital heart defect.

• Heart transplant- A heart transplant will be needed if there is a severe heart defect. This would involve finding a healthy donor and replacing the dysfunctional heart with a healthy heart to increase the life span.

• Fetal cardiac intervention- If a severe defect is recognised before birth, a procedure is conducted during pregnancy to reduce complication post birth. This is to help the child to be born with better chances of survival.

• Vessels- aorta/ PA branches

This encompasses the angiography and angioplasty procedure that help clear any blocked arteries that could cause problems. Angiography is conducted to examine the blood vessels and any inconsistencies in the heart. Angioplasty is a corrective action or measure to rectify the defect or diseased portion of the heart.

Angiography

Angiography is when doctors look at the blood vessel in minute detail with the help of X-rays. If the doctors identify a narrowed blood vessel, it could be widened or stretched by angioplasty.

Procedure for angiography

It is a procedure that lets doctors examine blood vessels and produces an angiogram that produces an image of the blood vessel. It is more of a road map that shows the path of blood vessels and junctions.

Blood vessels narrow owing to illness that affects the whole body. A narrowed blood vessel could cause reduced blood flow to the part of the body it supplies to.

A special dye called “contrast medium” is injected through a flexible tube called a catheter into the artery from the groin or arm. This will highlight potential issues in the blood vessel, and an X-ray will be taken for further action. With the help of the corrective dye, the images will highlight the portion of the heart where there is a defect. This will help the surgeon to determine the issue and the further course of action.

The procedure is safe and painless and will take about 30 minutes to two hours. After an angiography, there will be some soreness or bruising for a week or two. Sometimes there could be complications as a reaction to the dye, like dizziness, shortness of breath or severe allergy. These side effects are rare and can be treated.

Angioplasty

If the angiography diagnoses a block in the artery, the doctor may suggest an angioplasty procedure to avoid major surgery. This process is done to widen the valve and improve the blood flow from the blocked or narrowed artery.

Procedure for angioplasty

The procedure for angioplasty is similar to angiography. A thin, flexible tube called a catheter is inserted into the artery where there is a blockage. A special balloon is fitted to the catheter and inflated at the site using water pressure to relieve the block and let the blood flow through. The balloon is then deflated and taken out. This procedure is called balloon angioplasty.

This process may have to be repeated several times for more than one blockage or until the artery is completely clear. If it does not clear at this stage, the doctor may insert a stent within the artery to keep the walls apart and improve blood flow. The stents are made of a wire mesh coated with medication to keep the artery open.

Patients with multiple blockages or other coexisting medical conditions like diabetes may be recommended for coronary artery bypass surgery. 

Angioplasty is a safe process with minimum side effects.   Recovery time after angioplasty is about a week. Doctors will advise about the activity one can undertake and organise routine check-ups to monitor progress.

• Percutaneous valve replacement

In a minimally invasive procedure, percutaneous valve replacement is performed to replace a diseased heart valve. The malfunctioning valve is replaced with a manufactured one that functions mechanically. Some other valve replacements are crafted from animal or human tissue harvested from the membrane enveloping the patient's heart.

Why is percutaneous valve replacement performed?

Patients with severe diseases relating to the heart valve, especially those old and those with significant comorbidities and co-existing conditions that will preclude open heart surgery, will be recommended for percutaneous valve replacement.

Currently, percutaneous valve replacements are only performed for aortic and pulmonary valves. Only valve repairs and dilatation are performed percutaneously in the mitral and tricuspid valves.

A doctor may suggest percutaneous valve replacement to treat the following conditions,

• The backflow of blood from the aorta to the left ventricle is also called aortic regurgitation. This happens due to

• Deterioration of the valve

• Bacterial infection or endocarditis

• Obstruction to blood flow due to aortic valve stenosis

• Congenital heart condition along with a deformed aortic valve that could lead to regurgitation or obstruction

• Pulmonary hypertension and a malfunctioning pulmonary valve could lead to pulmonary regurgitation.

Procedure

A flexible thin tube called the catheter carries the valve to the heart through the blood vessels and puts it in place. The catheter is inserted in any of the below places,

• From an artery in the wrist which is called transradial

• From the ribs into the apex of the heart, which is called transapical

• From the neck, which is called transjugular

• From the groin, which is called transfemoral

A cardiologist will use ultrasonography and a continuous X-ray machine ( fluoroscopy) for images that will guide them through the process.

Developments in percutaneous valve replacement techniques

The field of percutaneous valve replacement or percutaneous repair is a developing field. While valvuloplasty, repair and balloon dilation of heart valves are being conducted extensively, most valve replacement techniques and devices are still in the nascent stage of development.

At the moment, percutaneous valve replacement can be done for only one patient at high risk for open-heart surgery. Research is in progress to make it available as a less invasive option to patients at low risk.

Percutaneous valve replacement is performed only on high-risk patients for open heart surgery. Studies are ongoing to make it available as a less-invasive option for low-risk patients.

Percutaneous valve replacement is conducted in the four significant valves of the heart. Below is a broad overview of the process and the developments,

• Aortic valve

Percutaneous aortic valve replacement or transcatheter aortic valve replacement is an established treatment in certain conditions. Balloon valvuloplasty is a temporary procedure for narrowing the aortic valve.

• Mitral valve

Percutaneous balloon valvuloplasty is performed to dilate the mitral valve, and percutaneous mitral valve repair has been done only in clinical trials until now.

• Pulmonary valve

Percutaneous pulmonary valve replacement is one of the largest procedures for those with congenital heart disease.

• Tricuspid valve

Percutaneous tricuspid valve repair procedures are being performed under clinical trials, and the replacement procedure is in the early stages of development.

Book an appointment at Manipal Hospitals to know more about treatments with the help of best cardiologists in Bangalore.