Get Corrective Surgery Done to Save Your Child’s Life

It can be a harrowing experience for parents to discover that their little bundle of joy has some congenital defect. It’s worse when they find that it is a hole in the heart, which the doctors call atrial septal defect (ASD). Don’t feel lost, since there is much that can be done about it. Quite often, nothing is detected until the child is at least a teenager. This can happen due to two reasons.

Asymptomatic child: The first is that the hole is very small, so the child remains asymptomatic; i.e. does not display any distress associated with ASD. Over the years, the hole might close by itself, in which case no further action is required. Such patients survive well into the adult years and lead normal lives; though it is unlikely that they would grow up to be successful in action sports.

Negligence: The second reason is more worrisome. The child has been displaying symptoms which might have been ignored for varied reasons. The primary reason for this negligence is the tendency of people to devalue or ignore complaints of small children, especially of girls. The child might be suffering from something else which has become the focus of attention. Sometimes, the breathlessness and tendency to tire easily is confused with asthma.

These Conditions Should Alert You
Since patients with ASD have a 70 percent greater risk of death compared to the general population; you should be watchful for your child displaying one or more symptoms. Rush to the nearest cardiologist if your baby:

  • Displays swelling of the abdomen without gas, or of the legs or arms (edema);
  • Becomes breathless when walking or running;
  • Tires out easily, or is constantly fatigued;
  • Suffers from palpitations, or skipped heartbeats (arrhythmia);
  • Heart murmur or whooshing sound is heard through the stethoscope during a regular checkup.

What Harm Does ASD Cause?
Patients with ASD, even children, run a greater risk of sustaining a stroke. An atrial septal defect (ASD) allows freshly oxygenated blood to flow from the left upper chamber of the heart (left atrium) into the right upper chamber of the heart (right atrium). This causes oxygenated blood to mix with deoxygenated blood creating complications like overfilling the lungs leading to pulmonary hypertension, and in rarer cases permanent damage to the lungs. The right side of the heart is overworked, eventually causing it to weaken and get enlarged. The patient might also suffer from arrhythmia, and heart failure eventually.

Diagnosis: ASD can be diagnosed through an electrocardiogram (ECG); chest x-ray; a computerized tomography (CT) scan; an echocardiogram; or magnetic resonance imaging (MRI); or even through cardiac catheterization.

Ensure Your Child Is Cured
It is up to you to ensure that your child is cured, and leads a normal adult life. While up to 25 percent of children with ASD are healed naturally with the hole closing naturally; it is the parents’ responsibility to ensure that appropriate interventions are made in a timely fashion to cure the child. Search for a dependable facility with state of the art technology needed for accurate diagnosis, and world-class cardiac surgeons to guide you on what would be the desirable way forward.

What Are Your Options?
In case of large holes, the cardiologist might choose to operate on your child. It is your right to ask for other equally effective options. Surgery should be the last option. Procedures done through transcatheter device occlusion can close abnormal openings or holes within the heart or blood vessels without surgery. This procedure is used to close secundum ASD, the most common type of ASD. For this procedure, your child is given medicine for him/her to sleep through it, and not feel any pain.

How it works: A catheter, with a tiny umbrella-like device folded up inside it, is inserted into a vein in the groin. When the catheter reaches the septum, the device is pushed out of the catheter and positioned to plug the hole between the atria. The device is secured in place, and the catheter is withdrawn from the body. Within six months, normal tissue grows in and over the device. There is no need to replace the closure device as the child grows.

Avoid post-surgical complications: Advantages of such a procedure include swifter and easier recovery as only a tiny puncture is made in the skin. Congenital heart defects requiring open heart surgery include holes in the heart, valve problems, narrow arteries, and other, more complex conditions. Until the early 1990s, surgery was the usual method for closing all ASDs. Now, it has been replaced by catheterization largely to prevent post-surgical complications in the not so large holes.

Do this when your child is recuperating:

  • Prevent blows to the chest, and similar accidents as the incision heal,
  • Limit activity while your child recovers,
  • Ensure regular bathing,
  • Schedule follow-up medical appointments,
  • Determine when your child can go back to his or her school and other regular activities.
Content Reviewed by – Asian Hospital Medical Editors