Heart Surgery in Newborns : Safe & effective with timely Expert Care

Out of every 1000 children born, 8 will be born with congenital heart disease. This means about 2.5-3L children are born with congenital heart disease every year in India. Many will die without treatment in the first year of life. Hence, it is important to operate on these children on time. 

Heart disease in newborns can be picked up by symptoms and tests. One of the simple ways to identify is checking the oxygen level of  babies with pulse oxymeter. Blue babies can be identified this way. The other symptoms by which heart disease is suspected is fast breathing, failure to gain weight, not able to feed and excessive sweating. When the heart has a defect, sounds called murmurs are produced. The pediatricians can suspect the diagnosis from the murmur.  

Once the heart problem is suspected the patient is referred to a pediatric cardiologist. One of three possible outcomes from this consultation - Medical management, Intervention or Surgery. Sometimes the condition can be minor and followed up. On other occasions, the hole may close by itself. There are conditions which can be handled without surgery. These are called interventions. The cardiologists, through peripheral vessels, close the hole in the heart or open up blocked valves. The patients usually do not need ICU stay and can be discharged in one or two days. There will be no scar.  

However, particularly in small babies or complex cases, intervention may not be possible. Open heart surgery will be required. The best results are in specialized centres who operate on children with heart disease in high volumes. A multi disciplinary approach is required with a team of cardiologists, surgeons, anaesthetists, intensivists, perfusionists and nursing staff.  

An old belief is that small babies will not survive open heart surgery. This is wrong. while heart surgeries are challenging, the results are excellent when done on time. A condition called Total Anomalous Pulmonary Venous Connection (TAPVC) may require surgery in the first day of life. Transposition of Great Arteries (TGA) may need surgery in the first one or two weeks of life. A Ventricular Septal Defect  (VSD- hole in the heart) may require surgery in the first two-three months. Complex conditions like Common AV canal defect or Truncus Arteriosus may need surgery at the earliest- within three months. These are all being done with excellent results.

Parents should be educated so that the results can be excellent. In fact, delay in surgery can cause worse results.

Featuring insights from Dr Neville Solomon, Paediatric Cardiac Surgeon, Apollo Children's Hospitals, Chennai. 

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