How is congenital heart disease treated?
As part of the promotion to help children with heart disease, we continue a series of publications on the topics: What is congenital heart disease (congenital heart disease)? What variants of the Air Force exist or the Air Force classification? What is endovascular treatment (surgery)? And also stories of children with heart defects who will be helped within the action. Today, we will tell you how to diagnose congenital heart disease?
There are two main options for the treatment of congenital heart disease:
Endovascular (intravascular) treatment with various catheters, balloons, occluders and other devices to restore the defect and normal blood circulation.
Open cardiac surgery to perform radical surgical correction of heart disease.
The choice of treatment depends entirely on the type and severity of congenital heart disease. The child’s age, height, weight and general health play a significant role in the choice of treatment tactics. The treatment may require both simple intervention and complex reconstructive and reconstructive surgery. Sometimes, to improve the results of treatment, it is divided into several successive stages. In case of complex combined defects, several endovascular or surgical interventions may be used during the entire treatment period.
Endovascular (intravascular) interventions using special endovascular devices.
The use of endovascular technologies in the treatment of congenital heart disease has opened up new possibilities in the treatment of this severe cardiac pathology. The essence of endovascular treatment is to introduce into the lumen of a vein or artery of various intravascular devices (catheters, balloons, stents, occluders, etc.), bringing them through the vascular bed to the area of pathology and their implementation of various therapeutic procedures. This approach has a number of undeniable advantages over open surgery. First of all, there is no need for extensive traumatic surgical access to the heart (most often a midline sternotomy or thoracotomy). Endovascular intervention reduces the duration of the operation and the need for general anesthesia or serious maintenance therapy. This means
For almost 20 years of endovascular treatment of congenital heart disease, intravascular treatment has proven itself well and in recent years has been used as the method of choice in the treatment of most simple birth defects. Among them, the most common are:
Atrial septal defect (atrial septum).
At DMPP in a gleam of a vein insert a special catheter and advance it towards an interatrial partition. At the tip of this catheter in the folded state is a tiny device, which is installed in the projection of the DMPP and open like an "umbrella". This device is called an occluder for the heart. The most common version of this occluder is the Amplatzer occluder. Once opened, the occluder completely occludes the atrial message and disconnects from the delivery catheter. After installation of the Amplatzer occluder in the atrial septal defect, obligatory angiographic control of the correctness of its position and the absence of pathological discharge of blood from the left atrium to the right.
Open arterial duct (Botal duct).
Currently, there is no botal duct that cannot be closed by a non-traumatic endovascular method that will avoid incisions, scars and prolonged rehabilitation. Surgical treatment of this defect is a thing of the past, with surgeons closing the botal ducts only to premature babies or in countries where medicine is underfunded. In all developed countries of Europe and America, this defect is eliminated exclusively endovascularly in X-ray surgery. In addition, the likelihood of complications during endovascular treatment is much lower.
Pulmonary artery valve stenosis.
As in the case of DMPP, the endovascular surgeon inserts a catheter into the lumen of the vein and places it in the projection of the narrowed valve of the pulmonary artery. At the tip of the catheter is a canister, which is asleep. This catheter is correctly placed in the projection of the valve and perform its inflation, which expands (dilates) the valve or area of stenosis of the pulmonary artery valve and restores normal vascular patency and pulmonary valve function. The procedure itself is called balloon dilatation of the valve. Thanks to this procedure, it is possible to treat stenosis of any heart valve.
During surgery, surgeons often use transesophageal echocardiography (EchoCG) or angiography to monitor the correctness of endovascular treatment. Transesophageal echocardiography is a special version of echocardiography in which an ultrasound sensor is located on the tip of an endoscope, which is located in the esophagus and used to scan the posterior parts of the heart, which is difficult to do with conventional transthoracic echocardiography. This method of research is also sometimes used in the diagnosis of complex combined heart defects.
Often endovascular technique is used as an adjunct or one of the stages of surgical treatment in the correction of complex defects.
Surgery or surgery .
Usually during cardiac probing the question of the choice of one or another type of treatment is decided. If the endovascular surgeon rules out the possibility of endovascular closure of the atrial septal defect or restoration of valve function, there is a need for open reconstructive surgery.
In complex congenital heart defects, several consecutive surgical procedures are often used.
Currently, there are the following main options for surgery for congenital heart disease:
• If there are defects in the septum, they are sutured with a suture (with a small hole size) or closed with a patch (with large defects or no septum).
• Plastic surgery, replacement or implantation of artificial heart valves.
• Prosthetics and plastics of large arteries or valvuloplasty of heart valves.
• Reconstruction of complex defects, such as pathology, accompanied by incorrect location and communication of large vessels in relation to the heart.
Rarely do newborns have such complex defects that high-tech surgery does not bring good results. In such cases, the best option for treating the pathology is a heart transplant.
There are two main options for the treatment of congenital heart disease:
Endovascular (intravascular) treatment with various catheters, balloons, occluders and other devices to restore the defect and normal blood circulation.
Open cardiac surgery to perform radical surgical correction of heart disease.
The choice of treatment depends entirely on the type and severity of congenital heart disease. The child’s age, height, weight and general health play a significant role in the choice of treatment tactics. The treatment may require both simple intervention and complex reconstructive and reconstructive surgery. Sometimes, to improve the results of treatment, it is divided into several successive stages. In case of complex combined defects, several endovascular or surgical interventions may be used during the entire treatment period.
Endovascular (intravascular) interventions using special endovascular devices.
The use of endovascular technologies in the treatment of congenital heart disease has opened up new possibilities in the treatment of this severe cardiac pathology. The essence of endovascular treatment is to introduce into the lumen of a vein or artery of various intravascular devices (catheters, balloons, stents, occluders, etc.), bringing them through the vascular bed to the area of pathology and their implementation of various therapeutic procedures. This approach has a number of undeniable advantages over open surgery. First of all, there is no need for extensive traumatic surgical access to the heart (most often a midline sternotomy or thoracotomy). Endovascular intervention reduces the duration of the operation and the need for general anesthesia or serious maintenance therapy. This means
For almost 20 years of endovascular treatment of congenital heart disease, intravascular treatment has proven itself well and in recent years has been used as the method of choice in the treatment of most simple birth defects. Among them, the most common are:
Atrial septal defect (atrial septum).
At DMPP in a gleam of a vein insert a special catheter and advance it towards an interatrial partition. At the tip of this catheter in the folded state is a tiny device, which is installed in the projection of the DMPP and open like an "umbrella". This device is called an occluder for the heart. The most common version of this occluder is the Amplatzer occluder. Once opened, the occluder completely occludes the atrial message and disconnects from the delivery catheter. After installation of the Amplatzer occluder in the atrial septal defect, obligatory angiographic control of the correctness of its position and the absence of pathological discharge of blood from the left atrium to the right.
Open arterial duct (Botal duct).
Currently, there is no botal duct that cannot be closed by a non-traumatic endovascular method that will avoid incisions, scars and prolonged rehabilitation. Surgical treatment of this defect is a thing of the past, with surgeons closing the botal ducts only to premature babies or in countries where medicine is underfunded. In all developed countries of Europe and America, this defect is eliminated exclusively endovascularly in X-ray surgery. In addition, the likelihood of complications during endovascular treatment is much lower.
Pulmonary artery valve stenosis.
As in the case of DMPP, the endovascular surgeon inserts a catheter into the lumen of the vein and places it in the projection of the narrowed valve of the pulmonary artery. At the tip of the catheter is a canister, which is asleep. This catheter is correctly placed in the projection of the valve and perform its inflation, which expands (dilates) the valve or area of stenosis of the pulmonary artery valve and restores normal vascular patency and pulmonary valve function. The procedure itself is called balloon dilatation of the valve. Thanks to this procedure, it is possible to treat stenosis of any heart valve.
During surgery, surgeons often use transesophageal echocardiography (EchoCG) or angiography to monitor the correctness of endovascular treatment. Transesophageal echocardiography is a special version of echocardiography in which an ultrasound sensor is located on the tip of an endoscope, which is located in the esophagus and used to scan the posterior parts of the heart, which is difficult to do with conventional transthoracic echocardiography. This method of research is also sometimes used in the diagnosis of complex combined heart defects.
Often endovascular technique is used as an adjunct or one of the stages of surgical treatment in the correction of complex defects.
Surgery or surgery .
Usually during cardiac probing the question of the choice of one or another type of treatment is decided. If the endovascular surgeon rules out the possibility of endovascular closure of the atrial septal defect or restoration of valve function, there is a need for open reconstructive surgery.
In complex congenital heart defects, several consecutive surgical procedures are often used.
Currently, there are the following main options for surgery for congenital heart disease:
• If there are defects in the septum, they are sutured with a suture (with a small hole size) or closed with a patch (with large defects or no septum).
• Plastic surgery, replacement or implantation of artificial heart valves.
• Prosthetics and plastics of large arteries or valvuloplasty of heart valves.
• Reconstruction of complex defects, such as pathology, accompanied by incorrect location and communication of large vessels in relation to the heart.
Rarely do newborns have such complex defects that high-tech surgery does not bring good results. In such cases, the best option for treating the pathology is a heart transplant.