PDA Surgery In India
PDA ligation is used in full-term infants who show signs of heart failure or signs of excessive stress on the blood vessels in the lungs. The goal of PDA ligation is to repair the patent ductus arteriosus before the lungs become diseased from too much blood flow and pressure. A surgeon closes the ductus arteriosus by tying or clipping it, without opening the heart. An incision is made on the left side of the chest near the armpit, through which the PDA is exposed where it attaches to the aorta. The tie or clip is placed directly around the PDA and the flow across the PDA is stopped immediately. Clipping or tying can also be done through four small incisions on the left side of the chest, with special instruments designed for use through such tiny incisions. If the infant has no symptoms, the operation can be postponed until 6 months to 3 years of age. PDA ligation is performed under general anesthesia.
Heart Valves Surgery in India
Four valves control the flow of blood from the atria to the ventricles and from the ventricles into the 2 large arteries connected to the heart.
The 4 valves are : –
- The tricuspid (tri-CUSS-pid) valve in the right side of the heart, between the right atrium and the right ventricle
- The pulmonary (PULL-mun-ary) valve in the right side of the heart, between the right ventricle and the entrance to the pulmonary artery that carries blood to the lungs
- The mitral (MI-trul) valve in the left side of the heart, between the left atrium and the left ventricle
- The aortic (ay-OR-tik) valve in the left side of the heart, between the left ventricle and the entrance to the aorta, the artery that carries blood to the body.
Valves are like doors that open and close. They open to allow blood to flow through to the next chamber or to one of the arteries, and then they shut to keep blood from flowing backwards.
How is Patent Ductus Arteriosus Diagnosed? Your child’s doctor will take a family and medical history, do a physical examination, and order several tests to diagnose your child’s PDA.
Infants born with a large PDA may have symptoms of congestive heart failure within the first few months of life. They are usually diagnosed at that time (even earlier if the baby is premature).
Infants with a small PDA may not be diagnosed until they are older. If your child’s doctor hears a heart murmur and suspects that it is due to a congenital heart defect, he or she will refer your child to a paediatric cardiologist. A paediatric cardiologist is a doctor who specializes in diagnosing and treating heart problems in children.
How Is Patent Ductus Arteriosus Treated?
Patent ductus arteriosus (PDA) is treated with medicines, catheter-based procedures, and surgery. The goal of treatment is to close the PDA to prevent complications and reverse the effects of increased blood volume.
Small PDAs often close without treatment. For full-term infants, treatment is needed if the child’s PDA is large or causing health problems.
For premature infants, treatment is needed if the PDA is causing breathing problems or heart problems.
Talk to your child’s doctor about treatment options and your family’s preferences on treatment decisions.
What Causes Patent Ductus Arteriosus?
The cause of PDA is not known.
Heredity may play a role. A defect in one or more genes or a chromosome abnormality could prevent the ductus arteriosus from closing normally after birth.
PDA is more common in : –
- Premature infants (babies born too early)
- Infants with genetic abnormalities such as Down syndrome
- Infants whose mother had German measles (rubella) during pregnancy.
Surgery in India
Surgery for PDA may be done if : –
- A premature or full-term infant develops health problems from the PDA and is too small to have a catheter-based procedure
- A PDA isn’t successfully closed by a catheter-based procedure
- Surgery is planned for treatment of related congenital heart defects
Often, surgery isn’t done until after 6 months of age in infants who don’t have health problems from their PDAs. Doctors sometime perform surgery on small PDAs to prevent the risk of IE.
For the surgery, your child will be given medicine so that he or she will sleep and not feel any discomfort. The surgeon will make a small cut between your child’s ribs to reach the PDA. He or she will then close the PDA with stitches or clips.
Complications from surgery are rare and usually short term. They can include hoarseness, a paralyzed diaphragm (the muscle below the lungs), infection, bleeding, or fluid buildup around the lungs.
After Surgery in India
After surgery, your child will spend a few days in the hospital. He or she will be given medicines to reduce pain and anxiety. Most children go home 2 days after surgery. Premature infants usually have to stay in the hospital longer because of their other health issues.
The doctors and nurses at the hospital will teach you how to care for your child at home.
They will talk to you about : –
- Limits on activity for your child while he or she recovers
- Followup appointments with your child’s doctors
- How to give your child medicines at home, if needed
When your child goes home after surgery, you can expect that he or she will feel fairly comfortable, although there may be some short-term pain.