-Contributed by Navaneeth R.
It is estimated that on average, over 200,000 children are born with congenital heart disease (CHD) in India. These are defects in the structure or function of the heart present at birth. Unlike in the past where treatment options were limited, the past few decades have witnessed significant advancements in congenital heart defect treatment including procedures that fix the heart without major surgery. These minimally invasive procedures have considerably reduced recovery time and reduced complications in children without compromising on the long-term outcomes.
How does Minimally Invasive Treatment Work?
Not all cases of CHD can be treated by minimally invasive methods. Careful selection and evaluation of patients are required before they are advised to undergo these procedures. Generally, interventions are done via thin catheters introduced into the heart through major blood vessels. This completely avoids the need for opening the chest to access the heart. Children with certain types of septal defects are good candidates for a minimally invasive procedure called device closure. In this procedure, the doctor inserts a small thin catheter through a puncture in the groin and advances it into the heart through the blood vessels under fluoroscopic guidance, an imaging technique using x ray. Once the catheter reaches the defect, a specially designed device is deployed through the catheter which is then expanded. It anchors in the place and closes the defect effectively. Another type of CHD where minimally invasive techniques are commonly employed is patent ductus arteriosus (PDA) which is an abnormal connection between aorta and pulmonary arteries, the two great arteries arising from the heart. This connection is required in the fetal life, but when it is persistent, it leads to abnormal flow of blood and change in the normal pressure-volume dynamics of the heart. Coil closure of PDA is a minimally invasive method where a small coil (usually made up of platinum) is introduced into the heart through a catheter and then deployed to close the PDA. There will be clot formation over the coil which will effectively seal it off. It is also interesting to note that in some severe conditions like transposition of great vessels, tricuspid atresia, HLHS and coarctation of aorta, the ductus should be kept open to ensure survival and this same artery may be stented and kept open.
Other minimally invasive procedures include atrial septostomy, balloon mitral valvotomy and trans-catheter valve replacements to list a few.
Benefits of minimally invasive methods
There are numerous benefits for minimally invasive methods compared to the traditional open-heart surgery. Primarily, minimally invasive techniques do not require a large incision over the chest. Hence there will be minimal scars, less blood loss, faster recovery time and shorter hospital duration, all of which are beneficial to the child and the family. When done in experienced centers, these procedures have excellent outcomes that are comparable to surgery. Because of these factors, minimally invasive methods are a compelling choice of treatment for many children with congenital heart defect (CHD).
Pitfalls
As previously mentioned, not all children are suitable candidates for these procedures. There should be careful selection of cases. Also, not all cases of CHD can be treated with minimally invasive procedures. Only some types of ASD, VSD, PDA, valvular disorders are commonly treated. Surgery remains the gold standard treatment option for most major types of CHD with complicated anatomy and hemodynamics.
Connect with Children’s Healthcare Foundation
Although congenital heart defect treatment is cost effective in the long run, the initial costs can be overwhelming for most families. When a family is struggling to afford the treatment, finding the right heart care foundation in India for child heart surgery can make the difference. Genesis Foundation, a child heart foundation in India, with over 25 years of legacy, supports heart treatment of underprivileged children coming from families with monthly income less than Rs. 20,000 a month.
Remember, your small contribution can make a huge difference in the lives of these little hearts!
To know more about the child heart foundation in India, call at +91 96506 03438 or e-mail at contactus@genesis-foundation.net.
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