Dr Ramji Mehrotra

Overview

All expecting parents want their children to be healthy. However, in some cases, things don’t go as per usual. They might be born with congenital anomalies like a hole in their hearts. In medical language, this is termed an ASD(atrial septal defect). With modern-day developments in surgical science, the holes are easily treatable. Before undergoing such surgeries for your child, you need to know about the procedure, package price, and other details related to the surgery. This will help you to make an informed decision for your child.

What is ASD, or a hole in the heart?

ASD, or Atrial Septal Defect, is a medical term for a hole in the heart. This is congenital heart disease(in-born anomaly). The heart has four chambers- two upper chambers called atria and two lower chambers called ventricles. If any opening exists between the two upper chambers(right and left atria), the condition is known as a hole in the heart.

Also, read - Cerebral Palsy Symptoms in Babies - Risk Factor, Prevention, Treatment

What causes ASD?

Congenital heart defects are caused by problems early in the development of the heart, but there is often no clear cause. Environmental and genetic factors may be involved. VSDs can occur on their own or in conjunction with other congenital heart defects.

What are the symptoms associated with ASD?

ASDs are present from birth, but there are usually no associated symptoms, and the condition can go undetected until adulthood. In some cases, the defect is discovered by chance during a chest X-ray that reveals right-sided heart enlargement.

By the age of 50, an individual with an ASD may begin to exhibit symptoms such as:

-Breathing difficulties

-Fainting

-Heart rhythm irregularities

-Fatigue following light activity or exercise

Also, read - Pediatric Cardiology Surgery - Treating the Heart of Your Little Ones

Why does your child need surgery immediately?

If an ASD is not repaired, the extra blood flow to the right side of the heart and lungs may cause heart problems in the long run. Most of these issues do not manifest themselves until adulthood, usually around the age of 30 or later. In infants and children, complications are uncommon. Complications could include:

ASD causes the right side of the heart to work harder because it has to pump more blood to the lungs. The heart may become tired from the extra work and stop pumping properly over time.

Arrhythmias: Excess blood flowing into the right atrium as a result of an ASD can cause it to stretch and enlarge. Irregular heartbeats can develop as a result of this over time. Palpitations or a racing heart are examples of arrhythmia symptoms.

Stroke: Small blood clots that form on the right side of the heart are usually filtered out by the lungs. A blood clot can sometimes pass from the right atrium to the left atrium via an ASD and be pumped out of the body. This type of clot can travel to a brain artery, blocking blood flow, and result in a stroke.

Pulmonary hypertension (PH): This is defined as an increase in pulmonary arterial pressure. These arteries transport oxygen-rich blood from the heart to the lungs. PH can cause damage to the arteries and small blood vessels in the lungs over time. They thicken and stiffen, making blood flow through them more difficult.

Also, read - Adenotonsillectomy Indications in Children

Cost of a hole in heart surgery or ASD

The average cost of Arterial Septal Defect surgery in various cities in India starts from 2 lakh to 5 lakh. However, the cost may vary based on multiple factors, including:

• The age of the patient
• The severity of the condition
• Patient’s overall health condition
• The location of the hospital
• Experience of the doctor
• 7 days hospital charge
• Operation theatre charges
• Medicines and investigative tests related to the procedure

How can we help with the treatment?

If you want to undergo treatment for congenital heart disease in India, our health trip advisors serve as your guides throughout the medical treatment and will be physically present with you even before the treatment begins. The following will be provided to you:

• Opinions of expert physicians and surgeons
• Transparent communication
• Coordinated care
• Prior appointment with specialists
• Assistance with hospital formalities
• 24*7 availability
• Arrangement for travel
• Assistance for accommodation and healthy recovery
• Assistance in emergencies

We are dedicated to offering the highest quality health care to our patients. We have a team of highly qualified and devoted health trip advisors that will be by your side from the beginning of your journey.

Overview

Congenital heart disease(CHD) has become one of the most common birth anomalies. This can vary from a small defect to a severe malformation in the heart of a neonate. And in India, the estimated number of children born with CHD is more than 200,000 per year. The transposition of great arteries is one such condition. An arterial switch operation is a procedure that can treat such an anomaly. However, before undergoing the surgery, you should have an idea of the procedure and the complications associated with it. In this blog, we’ve discussed the same in brief, so that you can make an informed decision with your doctor.

Understanding the arterial switch procedure

The arterial switch is a surgical procedure and the primary treatment for great artery transposition (TGA). Almost all TGA children have their arterial switches repaired.

Babies with TGA become extremely ill soon after birth due to a severe lack of oxygen. The following are the two temporary measures that will help improve your baby's condition. Your doctor will conduct these procedures before proceeding with an arterial switch:

• Beginning of a medication known as prostaglandin
• Carrying out a balloon atrial septostomy

An arterial switch procedure is a type of open heart surgery that is typically performed within the first week of life.

During the procedure, the pulmonary artery and aorta return to normal positions. The coronary arteries are properly connected to the new aorta.

The surgeon will also correct any significant ventricular septal defects (holes between the ventricles) in your baby during the arterial switch procedure(if there are any).

Also, Read - Pediatric Cardiology Surgery - Treating the Heart of Your Little Ones

Complications associated with the arterial switch procedure

The arterial switch requires extensive surgery, but the outcomes are excellent. Almost all the surgeries are successful.

This procedure will need the use of a cardiopulmonary bypass (heart-lung machine).

However, many children might have minor issues such as:

• Nausea
• Feeding issues (such as trouble swallowing)
• Bruising at intravenous (IV) sites. An intravenous (IV) line is a small tube that is inserted into a vein in your child's arm or leg to administer medications or fluids.

Also, Read - Adenotonsillectomy Indications in Children

The following are rare but serious complications of anesthesia and heart surgery:

-Bruising, clotting, and strokes

-Injury to the vocal cords

-Drug interactions

-Heart rhythm issues

-Heart failure

-Blood transfusion reactions

-Brain damage

Apart from these, long-term complications include pulmonary artery stenosis, coronary artery obstruction, new aortic valvar insufficiency, arrhythmia, and aortic arch obstruction, which have all decreased significantly in recent years.

The most difficult aspect of the surgery is transferring the coronary arteries. A baby's heart is about the size of a fist. That's why it's not easy to see how small and delicate the coronary arteries are. The coronary arteries play a critical role in supplying blood to the heart. Any damage or even minor dilation of the coronary arteries can be fatal. To allow for proper localization and repositioning of both coronary arteries, great care must be taken.

Associated heart defects may also add to the surgery's complexity. The majority of patients with transposition of the great arteries also have an atrial septal defect and patent ductus arteriosus. These are usually addressed at the same time as the surgery. A ventricular septal defect may exist in some cases and must be repaired. Some patients have pulmonary valve stenosis or even narrowing beneath the pulmonary valve. This may significantly complicate the procedure and, in some cases, necessitate a completely different surgical approach. And some patients may have an associated aortic coarctation. This can also make the surgery more difficult.

Fortunately, the outcomes for a child undergoing an arterial switch operation are generally very good today. The majority of children do well and live normal, healthy lives.

Also, Read - Cerebral Palsy Symptoms in Babies - Risk Factor, Prevention, Treatment

How can we help with the treatment?

If you are in search of treatment for heart valve replacement for your child, we will serve as your guide throughout the medical treatment and will be physically present with you even before your child’s treatment begins. The following will be provided to you:

• Opinions of expert physicians and surgeons
• Transparent communication
• Coordinated care
• Prior appointment with specialists
• Assistance with hospital formalities
• 24*7 availability
• Arrangement for travel
• Assistance for accommodation and healthy recovery
• Assistance in emergencies

We are dedicated to offering the highest quality health care to our patients. We have a team of highly qualified and devoted health trip advisors that will be by your side from the beginning of your journey.

Overview

According to demographic data, the rate of heart disease among Indians is double that of the national average in the western world. Apart from CVD (cardiovascular disease) in young adults and the elderly population, there are various congenital anomalies that require immediate cardiac intervention (heart treatment). Transposition of the great arteries (TGA) is one such congenital(inborn) heart anomaly. And we believe if you’re here on this page, then you might have heard the term "arterial switch operation" from your doctor or heart specialist. The operation is performed to treat such anomalies. Here we’ve discussed the procedure in detail with the help of our experts, along with some common queries related to the same.

What do you mean by the transposition of great arteries?

The transposition of great arteries is an umbrella term for various congenital anomalies (inborn heart disorders) where the major blood vessels of the heart have switched places.

The aorta and pulmonary arteries are referred to as the "great arteries" in this defect. These are the two main arteries that drain blood from the heart.

Transposition of the great arteries occurs when these vessels begin in the wrong ventricle. They have been "transposed" from their original position. The aorta originates in the right ventricle, while the pulmonary artery originates in the left ventricle.

Transposition causes the systemic (to the body) and pulmonary (to the lungs) circulations to work in tandem rather than together. This means that the oxygen-depleted ("blue") blood that is returning from the body and passing through the right atrium and right ventricle is pumped out to the aorta and the body.

The pulmonary artery sends oxygen-rich ("red") blood returning from the lungs and passing through the left atrium and ventricle back to the lungs.

Hence, the organs of the body will not get enough oxygen that they need to function properly.

Also, Read - Types Of Heart Disease - Symptoms, Cause, Risk Factors

What are the signs and symptoms of transposition?

The signs of transposition can be detected while doing regular screening tests like ultrasound during pregnancy.

The following are the symptoms of transposition that can be observed right after birth:

• Cyanosis (blue color of the skin)
• Weak pulse
• Shortness of breath
• Poor appetite
• Weight loss
• Pounding heart

In babies born with transposition of the great arteries and other congenital heart defects, blue skin color may be less noticeable at first. This is due to the fact that other heart conditions, such as atrial septal defects, ventricular septal defects, or patent ductus arteriosus, may allow some oxygen-rich blood to enter the body. However, as the baby grows more active, the congenital heart defects will prevent enough blood from passing through, and the blue skin color will become visible.

Also, Read - Heart CT Scan - Know Heart Blockage Without Angiography

Treatment options available for transposition:

There are various surgical treatments available for the transposition of great arteries. However, the type of treatment may vary based on multiple factors, like:

• Age of the patient
• The overall health of the patient

However, most of these surgeries are open surgeries that require entering the chest to reach the heart. The two main options are:

• Arterial switch operation: The aorta and pulmonary arteries are severed and moved to their proper positions during this procedure. In most cases, it is regarded as the preferred option. Any holes in the heart may be sutured or allowed to close on their own during surgery if they are small.

• Atrial switch surgery: This procedure involves creating a tunnel (baffle) between the heart's two upper chambers (atria). This allows deoxygenated blood to enter the lungs and oxygenated blood to enter the aorta for distribution to the rest of the body.

How is transposition treated with an arterial switch operation?

An arterial switch is a surgical procedure and the primary treatment for great artery transposition (TGA). Almost all TGA children have their arterial switches repaired (also called the Jatene repair).

Babies with TGA become extremely ill soon after birth due to a severe lack of oxygen. Two temporary measures can improve your baby's condition before proceeding with an arterial switch:

• Beginning a medication known as prostaglandin
• Carrying out a balloon atrial septostomy

An arterial switch procedure is a type of open heart surgery that is typically performed within the first week of life.

How can we help with the treatment?

If you are in search of treatment for heart transplant for your child, we will serve as your guide throughout the treatment and will be physically present with you even before your child’s treatment begins. The following will be provided to you:

• Opinions of expert physicians and surgeons
• Transparent communication
• Coordinated care
• Prior appointment with specialists
• Assistance with hospital formalities
• 24*7 availability
• Arrangement for travel
• Assistance for accommodation and healthy recovery
• Assistance in emergencies

We are dedicated to offering the highest quality health care to our patients. We have a team of highly qualified and devoted health trip advisors that will be by your side from the beginning of your journey.