Paediatric CARDIAC TREATMENT IN INDIA /Paediatric Cardiac Surgery in India

Congenital Heart Defects / Congenital Heart Surgery in India

Heart Hole Closure Surgery –

Heart Hole closure surgery is done for Atrial Septal Defects ( ASD) and Ventricular Septal defects ( VSD) .

Atrial Septal Defect (ASD) – The Atrial Septal Defect (ASD) is the wall between the two upper chambers of the heart (right and left atria). An Atrial Septal Defect (ASD) is an abnormal hole in this wall. Atrial Septal Defect (ASD)   is a heart problem that is present at birth (congenital).

What Causes an Atrial Septal Defect?

The heart forms during the first 8 weeks of pregnancy. It starts as a hollow tube and divides into 4 chambers. These chambers are separated by walls (Septa). The openings usually close shortly before or just after birth. If they don’t all close, the Atrial Septum will have a hole in it. This is called an Atrial Septal Defect (ASD) .

Ventricular Septal Defect (VSD) is an opening in the dividing wall (septum) between the two lower chambers of the heart known as the right and left ventricles. Ventricular Septal Defect (VSD)  is a congenital (present at birth) heart defect. As the fetus grows, a problem with how the heart develops during the first 8 weeks of pregnancy results in a Ventricular Septal Defect (VSD)

Normally, oxygen-poor (blue) blood returns to the right atrium from the body, travels to the right ventricle, then is pumped into the lungs where it receives oxygen. Oxygen-rich (red) blood returns to the left atrium from the lungs, passes into the left ventricle, and then is pumped out to the body through the aorta.

Atrial Septal Defects (ASD) Treatment in India / Heart Hole Treatment in India / Ventricular Septal Defects treatment in India

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. The most common type of Atrial Septal Defect (ASD) may close on its own as your child grows.

Once an Atrial Septal Defect (ASD)  or a Ventricular Septal Defect ( VSD) is diagnosed, your child’s cardiologist will check your child to see if the defect is closing on its own. An Atrial Septal Defect (ASD)  or Ventricular Septal Defect ( VSD) will usually be fixed if it has not closed by the time a child starts school. The decision to close the Atrial Septal Defect (ASD) or Ventricular Septal Defect ( VSD) may also depend on the size of the defect.

Treatment may include:

  • Surgery for ASD in India / Surgery for Heart Hole in India. Your child’s Atrial Septal Defect (ASD) may be repaired by surgery.  In This surgery the doctors will close the hole in the heart by making a tiny hole through the chest, inserting a endoscope and close the hole with sutures and special tissue patch. Surgery is chosen for heart holes which are bigger in size. The surgery is done under general Anaesthesia. The defect may be closed with stitches or a special patch.
  • Device closure procedure for Heart Hole or ASDs in India –Some children are helped with this procedure. The doctor uses cardiac catheterization to put a special device (septal occluder) in the open . The device stops blood from flowing through the ASD. A catheter is inserted through the groin and the device is inserted through the Catheter and is left over the hole to close it. This procedure is chosen for small sized holes.

Patent Ductus Arteriosus (PDA) Treatment in India / PDA Surgery In India

Patent Ductus Arteriosus (PDA) is a heart defect found in the days or weeks after birth. The Ductus Arteriosus is a normal part of fetal blood circulation. All babies are born with this opening between the aorta and the pulmonary artery. But it usually closes on its own shortly after birth. If it stays open, it is called Patent Ductus Arteriosus (PDA). The blood vessels and the lungs have to work much harder to handle the extra blood.

What causes Patent Ductus Arteriosus (PDA)?

Doctors don’t know exactly why Patent Ductus Arteriosus (PDA)  occurs. It is more common in babies born prematurely. Patent Ductus Arteriosus (PDA)  can also occur along with other heart defects.

How is Patent Ductus Arteriosus (PDA) Treated / PDA Surgery In India

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. A small Patent Ductus Arteriosus (PDA) may close on its own as your child grows. A Patent Ductus Arteriosus (PDA) that causes symptoms will need to be treated with medicine or surgery. The cardiologist will check periodically to see whether the Patent Ductus Arteriosus (PDA) is closing on its own. If a Patent Ductus Arteriosus (PDA) does not close, it will be fixed to prevent lung problems. Treatment may include the following.


Surgery can repair or close PDAs. Repair is usually advised for babies younger than 6 months of age who have large defects and who have symptoms such as poor weight gain and fast breathing. For babies who do not have symptoms, any repairs may be delayed until after 6 to 12 months of age. Your child’s cardiologist will recommend when the repair should be done. Procedures include:

  • Transcatheter coil closure of the Patent Ductus Arteriosus (PDA)

 Heart catheterization is used to correct the Patent Ductus Arteriosus (PDA). Once the catheter is in the heart, the cardiologist uses a special device to close the Patent Ductus Arteriosus (PDA).Children need to be at least 11 pounds (5 kg) to be considered for transcatheter closure. Because of their small size, premature infants cannot have this procedure.

  • Surgical closure of the Patent Ductus Arteriosus (PDA) (PDA ligation). This is surgery done with sleep medicine (general anaesthesia). It involves closing the Patent Ductus Arteriosus (PDA) with stitches or clips. This prevents the extra blood from entering the lungs. Premature babies require this procedure.

Tetralogy of Fallot (TOF) Treatment in India / Surgery for TOF in India

Tetralogy of Fallot (TOF) is a condition of several related congenital (present at birth) defects that occur due to abnormal development of the fetal heart during the first 8 weeks of pregnancy.

Tetralogy of Fallot (TOF) involves four heart defects:

  • Ventricular septal defect (VSD). An opening in the ventricular septum, or dividing wall between the two lower chambers of the heart known as the right and left ventricles.
  •  Pulmonary (or right ventricular outflow tract) obstruction. A muscular obstruction in the right ventricle, just below the pulmonary valve, that decreases the normal flow of blood. The pulmonary valve may also be small.
  • Overriding aorta. The aorta is shifted towards the right side of the heart so that it sits over the ventricular septal defect.

“Tetralogy of Fallot (TOF)” refers to 4 heart problems. The fourth problem is that the right ventricle becomes thickened as it tries to pump blood past the obstruction into the pulmonary artery.

How is Tetralogy of Fallot (TOF) Treated in India / Surgery for TOF in India  –

Surgery is the only effective treatment for Tetralogy of Fallot (TOF)  . There are two types of surgery that may be performed, including intracardiac repair or a temporary procedure that uses a shunt. Most babies and children will have intracardiac repair.

 Intra-cardiac Repair Surgery in India

Tetralogy of Fallot (TOF)  treatment for most babies involves a type of open-heart surgery called intracardiac repair. This surgery is typically performed during the first year of life. During this procedure, the surgeon places a patch over the ventricular septal defect to close the hole between the ventricles. He or she also repairs the narrowed pulmonary valve and widens the pulmonary arteries to increase blood flow to the lungs. After intracardiac repair, the oxygen level in the blood increases and your baby’s symptoms will lessen.

Temporary Surgery for TOF in India

Occasionally babies need to undergo a temporary surgery before having intracardiac repair. If your baby was born prematurely or has pulmonary arteries that are underdeveloped (hypoplastic), doctors will create a bypass (shunt) between the aorta and pulmonary artery. This bypass increases blood flow to the lungs. When your baby is ready for intracardiac repair, the shunt is removed.

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