The results of a study conducted by the Department of Medicine, University of Ulsan, Korea, show that multivessel coronary stenting can be performed with a high success rate along with an acceptable clinical outcome. Coronary stenting has proven itself to be an accepted means for treating of obstructed coronary arteries. The need for multivessel coronary stenting has been inflated because of the larger number of patients with unfavourable cardiac profiles. Conventionally, bypass surgery is regarded as a standard means for relieving angina in cardiac patients with multivessel coronary disease as it could lead to a downright revascularization. Further, it also allows a prolongation of lifespan in a specified subgroup of patients.
How are they performed: Despite the coming of modern generation of stents, patients with multiple stringent arteries in the heart receiving coronary after bypass have recovered better than those whose arteries were grafted with balloon angioplasty or stenting. This report is presented in the 64th Annual Scientific Session in the American College of Cardiology. This report echoes past studies which shows that patients afflicted with multiple narrowed arteries receive better results with coronary artery bypass grafting, which is also known as CABG or bypass heart surgery. In case of multivessel stenting, which is known as angioplasty or percutaneous coronary intervention or PCI, a stent is put within the arteries to hold it wide open and facilitate the flow of blood.
Which one is better: In a new study, it is reported that patients with new stents are susceptible to 47% higher risk of any of the outcomes like death or cardiac arrest as compared to patients who undergo bypass surgery. In CABG, a vein or artery from other parts of the body is grafted on the constricted coronary artery for allowing easy blood flow to and from heart. This study reinforces present regulations that recommend CABG to treat patients with substantial constrictions in various arteries, a condition often termed as multivessel coronary artery ailment.
Renowned cardiologist Seung Jung Park from Asan Medical Centre in Seoul, South Korea opines that CABG is still a much preferred option on the basis of their medical data. Another study known as Bypass Surgery Versus Everolimus - Eluting Stent Implantation for Multivessel Coronary Artery Disease or BEST trial deserves mention. It is one of the two randomly controlled trials for comparing bypass to angioplasty since the introduction of modernised stents that emits medication, which would prevent blood clot.
This study was implemented on 880 patients at 27 healthcare centres in four countries. Each patient had multivessel coronary artery disease and were determined to be equally eligible to go through either of the methods. Half of these patients were randomly chosen to be given angioplasty with everolimus-eluting stents, and the other half received bypass surgery.
All the patients were tracked for about five years and during this prolonged follow up, angioplasty was related to a considerable upsurge in the incidence of myocardial infarction, target vessel revascularization and often death. Because, it is a more invasive process, bypass surgery is normally recommended only for patients afflicted with higher-risk constrictions in more than one artery.
If you are one of these patients and this concern plagues you, it is recommended to talk to your cardiologist without much delay.
The results of a study conducted by the Department of Medicine, University of Ulsan, Korea, show that multivessel coronary stenting can be performed with a high success rate along with an acceptable clinical outcome. Coronary stenting has proven itself to be an accepted means for treating of obstructed coronary arteries. The need for multivessel coronary stenting has been inflated because of the larger number of patients with unfavourable cardiac profiles. Conventionally, bypass surgery is regarded as a standard means for relieving angina in cardiac patients with multivessel coronary disease as it could lead to a downright revascularization. Further, it also allows a prolongation of lifespan in a specified subgroup of patients.
How are they performed: Despite the coming of modern generation of stents, patients with multiple stringent arteries in the heart receiving coronary after bypass have recovered better than those whose arteries were grafted with balloon angioplasty or stenting. This report is presented in the 64th Annual Scientific Session in the American College of Cardiology. This report echoes past studies which shows that patients afflicted with multiple narrowed arteries receive better results with coronary artery bypass grafting, which is also known as CABG or bypass heart surgery. In case of multivessel stenting, which is known as angioplasty or percutaneous coronary intervention or PCI, a stent is put within the arteries to hold it wide open and facilitate the flow of blood.
Which one is better: In a new study, it is reported that patients with new stents are susceptible to 47% higher risk of any of the outcomes like death or cardiac arrest as compared to patients who undergo bypass surgery. In CABG, a vein or artery from other parts of the body is grafted on the constricted coronary artery for allowing easy blood flow to and from heart. This study reinforces present regulations that recommend CABG to treat patients with substantial constrictions in various arteries, a condition often termed as multivessel coronary artery ailment.
Renowned cardiologist Seung Jung Park from Asan Medical Centre in Seoul, South Korea opines that CABG is still a much preferred option on the basis of their medical data. Another study known as Bypass Surgery Versus Everolimus - Eluting Stent Implantation for Multivessel Coronary Artery Disease or BEST trial deserves mention. It is one of the two randomly controlled trials for comparing bypass to angioplasty since the introduction of modernised stents that emits medication, which would prevent blood clot.
This study was implemented on 880 patients at 27 healthcare centres in four countries. Each patient had multivessel coronary artery disease and were determined to be equally eligible to go through either of the methods. Half of these patients were randomly chosen to be given angioplasty with everolimus-eluting stents, and the other half received bypass surgery.
All the patients were tracked for about five years and during this prolonged follow up, angioplasty was related to a considerable upsurge in the incidence of myocardial infarction, target vessel revascularization and often death. Because, it is a more invasive process, bypass surgery is normally recommended only for patients afflicted with higher-risk constrictions in more than one artery.
If you are one of these patients and this concern plagues you, it is recommended to talk to your cardiologist without much delay.
The results of a study conducted by the Department of Medicine, University of Ulsan, Korea, show that multivessel coronary stenting can be performed with a high success rate along with an acceptable clinical outcome. Coronary stenting has proven itself to be an accepted means for treating of obstructed coronary arteries. The need for multivessel coronary stenting has been inflated because of the larger number of patients with unfavourable cardiac profiles. Conventionally, bypass surgery is regarded as a standard means for relieving angina in cardiac patients with multivessel coronary disease as it could lead to a downright revascularization. Further, it also allows a prolongation of lifespan in a specified subgroup of patients.
How are they performed: Despite the coming of modern generation of stents, patients with multiple stringent arteries in the heart receiving coronary after bypass have recovered better than those whose arteries were grafted with balloon angioplasty or stenting. This report is presented in the 64th Annual Scientific Session in the American College of Cardiology. This report echoes past studies which shows that patients afflicted with multiple narrowed arteries receive better results with coronary artery bypass grafting, which is also known as CABG or bypass heart surgery. In case of multivessel stenting, which is known as angioplasty or percutaneous coronary intervention or PCI, a stent is put within the arteries to hold it wide open and facilitate the flow of blood.
Which one is better: In a new study, it is reported that patients with new stents are susceptible to 47% higher risk of any of the outcomes like death or cardiac arrest as compared to patients who undergo bypass surgery. In CABG, a vein or artery from other parts of the body is grafted on the constricted coronary artery for allowing easy blood flow to and from heart. This study reinforces present regulations that recommend CABG to treat patients with substantial constrictions in various arteries, a condition often termed as multivessel coronary artery ailment.
Renowned cardiologist Seung Jung Park from Asan Medical Centre in Seoul, South Korea opines that CABG is still a much preferred option on the basis of their medical data. Another study known as Bypass Surgery Versus Everolimus - Eluting Stent Implantation for Multivessel Coronary Artery Disease or BEST trial deserves mention. It is one of the two randomly controlled trials for comparing bypass to angioplasty since the introduction of modernised stents that emits medication, which would prevent blood clot.
This study was implemented on 880 patients at 27 healthcare centres in four countries. Each patient had multivessel coronary artery disease and were determined to be equally eligible to go through either of the methods. Half of these patients were randomly chosen to be given angioplasty with everolimus-eluting stents, and the other half received bypass surgery.
All the patients were tracked for about five years and during this prolonged follow up, angioplasty was related to a considerable upsurge in the incidence of myocardial infarction, target vessel revascularization and often death. Because, it is a more invasive process, bypass surgery is normally recommended only for patients afflicted with higher-risk constrictions in more than one artery.
If you are one of these patients and this concern plagues you, it is recommended to talk to a cardiologist without much delay.
The results of a study conducted by the Department of Medicine, University of Ulsan, Korea, show that multivessel coronary stenting can be performed with a high success rate along with an acceptable clinical outcome. Coronary stenting has proven itself to be an accepted means for treating obstructed coronary arteries. The need for multivessel coronary stenting has been inflated because of the larger number of patients with unfavourable cardiac profiles. Conventionally, bypass surgery is regarded as a standard means for relieving angina in cardiac patients with multivessel coronary disease as it could lead to downright revascularization. Further, it also allows a prolongation of lifespan in a specified subgroup of patients.
How are they performed: Despite the coming of modern generation of stents, patients with multiple stringent arteries in the heart receiving coronary after bypass has recovered better than those whose arteries were grafted with balloon angioplasty or stenting. This report is presented in the 64th Annual Scientific Session in the American College of Cardiology. This report echoes past studies which show that patients afflicted with multiple narrowed arteries receive better results with coronary artery bypass grafting, which is also known as CABG or bypass heart surgery. In case of multivessel stenting, which is known as angioplasty or percutaneous coronary intervention or PCI, a stent is put within the arteries to hold it wide open and facilitate the flow of blood.
Which one is better: In a new study, it is reported that patients with new stents are susceptible to 47% higher risk of any of the outcomes like death or cardiac arrest as compared to patients who undergo bypass surgery. In CABG, a vein or artery from other parts of the body is grafted on the constricted coronary artery for allowing easy blood flow to and from heart. This study reinforces present regulations that recommend CABG to treat patients with substantial constrictions in various arteries, a condition often termed as multivessel coronary artery ailment.
Renowned cardiologist Seung Jung Park from Asan Medical Centre in Seoul, South Korea opines that CABG is still a much-preferred option on the basis of their medical data. Another study known as Bypass Surgery Versus Everolimus-Eluting Stent Implantation for Multivessel Coronary Artery Disease or BEST trial deserves mention. It is one of the two randomly controlled trials for comparing bypass to angioplasty since the introduction of modernised stents that emits medication, which would prevent blood clot.
This study was implemented on 880 patients at 27 healthcare centres in four countries. Each patient had multivessel coronary artery disease and were determined to be equally eligible to go through either of the methods. Half of these patients were randomly chosen to be given angioplasty with everolimus-eluting stents, and the other half received bypass surgery.
All the patients were tracked for about five years and during this prolonged follow-up, angioplasty was related to a considerable upsurge in the incidence of myocardial infarction, target vessel revascularization and often death. Because, it is a more invasive process, bypass surgery is normally recommended only for patients afflicted with higher-risk constrictions in more than one artery.
If you are one of these patients and this concern plagues you, it is recommended to talk to your cardiologist without much delay.
The results of a study conducted by the Department of Medicine, University of Ulsan, Korea, show that multivessel coronary stenting can be performed with a high success rate along with an acceptable clinical outcome. Coronary stenting has proven itself to be an accepted means for treating of obstructed coronary arteries. The need for multivessel coronary stenting has been inflated because of the larger number of patients with unfavourable cardiac profiles. Conventionally, bypass surgery is regarded as a standard means for relieving angina in cardiac patients with multivessel coronary disease as it could lead to a downright revascularization. Further, it also allows a prolongation of lifespan in a specified subgroup of patients.
How are they performed?
Despite the coming of modern generation of stents, patients with multiple stringent arteries in the heart receiving coronary after bypass have recovered better than those whose arteries were grafted with balloon angioplasty or stenting. This report is presented in the 64th Annual Scientific Session in the American College of Cardiology. This report echoes past studies which shows that patients afflicted with multiple narrowed arteries receive better results with coronary artery bypass grafting, which is also known as CABG or bypass heart surgery. In case of multivessel stenting, which is known as angioplasty or percutaneous coronary intervention or PCI, a stent is put within the arteries to hold it wide open and facilitate the flow of blood.
Which one is better?
In a new study, it is reported that patients with new stents are susceptible to 47% higher risk of any of the outcomes like death or cardiac arrest as compared to patients who undergo bypass surgery. In CABG, a vein or artery from other parts of the body is grafted on the constricted coronary artery for allowing easy blood flow to and from heart. This study reinforces present regulations that recommend CABG to treat patients with substantial constrictions in various arteries, a condition often termed as multivessel coronary artery ailment.
Renowned cardiologist Seung Jung Park from Asan Medical Centre in Seoul, South Korea opines that CABG is still a much preferred option on the basis of their medical data. Another study known as Bypass Surgery Versus Everolimus - Eluting Stent Implantation for Multivessel Coronary Artery Disease or BEST trial deserves mention. It is one of the two randomly controlled trials for comparing bypass to angioplasty since the introduction of modernised stents that emits medication, which would prevent blood clot.
This study was implemented on 880 patients at 27 healthcare centres in four countries. Each patient had multivessel coronary artery disease and were determined to be equally eligible to go through either of the methods. Half of these patients were randomly chosen to be given angioplasty with everolimus-eluting stents, and the other half received bypass surgery.
All the patients were tracked for about five years and during this prolonged follow up, angioplasty was related to a considerable upsurge in the incidence of myocardial infarction, target vessel revascularization and often death. Because, it is a more invasive process, bypass surgery is normally recommended only for patients afflicted with higher-risk constrictions in more than one artery.
If you are one of these patients and this concern plagues you, it is recommended to talk to your cardiologist without much delay.
The results of a study conducted by the Department of Medicine, University of Ulsan, Korea, show that multivessel coronary stenting can be performed with a high success rate along with an acceptable clinical outcome. Coronary stenting has proven itself to be an accepted means for treating of obstructed coronary arteries. The need for multivessel coronary stenting has been inflated because of the larger number of patients with unfavourable cardiac profiles. Conventionally, bypass surgery is regarded as a standard means for relieving angina in cardiac patients with multivessel coronary disease as it could lead to a downright revascularization. Further, it also allows a prolongation of lifespan in a specified subgroup of patients.
How are they performed: Despite the coming of modern generation of stents, patients with multiple stringent arteries in the heart receiving coronary after bypass have recovered better than those whose arteries were grafted with balloon angioplasty or stenting. This report is presented in the 64th Annual Scientific Session in the American College of Cardiology. This report echoes past studies which shows that patients afflicted with multiple narrowed arteries receive better results with coronary artery bypass grafting, which is also known as CABG or bypass heart surgery. In case of multivessel stenting, which is known as angioplasty or percutaneous coronary intervention or PCI, a stent is put within the arteries to hold it wide open and facilitate the flow of blood.
Which one is better: In a new study, it is reported that patients with new stents are susceptible to 47% higher risk of any of the outcomes like death or cardiac arrest as compared to patients who undergo bypass surgery. In CABG, a vein or artery from other parts of the body is grafted on the constricted coronary artery for allowing easy blood flow to and from heart. This study reinforces present regulations that recommend CABG to treat patients with substantial constrictions in various arteries, a condition often termed as multivessel coronary artery ailment.
This study was implemented on 880 patients at 27 healthcare centres in four countries. Each patient had multivessel coronary artery disease and were determined to be equally eligible to go through either of the methods. Half of these patients were randomly chosen to be given angioplasty with everolimus-eluting stents, and the other half received bypass surgery.
All the patients were tracked for about five years and during this prolonged follow up, angioplasty was related to a considerable upsurge in the incidence of myocardial infarction, target vessel revascularization and often death. Because, it is a more invasive process, bypass surgery is normally recommended only for patients afflicted with higher-risk constrictions in more than one artery.
If you are one of these patients and this concern plagues you, it is recommended to talk to a cardiologist without much delay.
It's International Women’s Day yet again. A time to celebrate women’s accomplishments- both those of legendary creators including Mother Teresa, Kiran Bedi, Anuradha Koirala – the anti-sex-trafficking activist & Mary Kom to name a few and the women in our lives who mentor and inspire us every day. It’s a day to celebrate our journey towards gender equality and women empowerment.
This year’s International Women’s Day theme is “Time is Now: Rural and urban activists transforming women's lives.” It comes on the heels of unprecedented global movement for women’s rights, equality, and justice. The theme has taken the global campaigns and marches on issues ranging from sexual harassment and femicide to equal pay and women’s political representation.
Women still have a long way to go to attain equality and non-discrimination from her male counterparts. 2018 International Women’s day is an 'iron in the fire opportunity' to bring a call to action to entrust women with what they actually deserve, not only in a particular sector but to every woman who resides in urban as well as rural areas. It is a step to respect and appreciate the women who step out every day for the livelihood of their families and kids - a step to stop casual sexism faced by urban women in the workplace.
Women, experiencing sexual harassment in the workplace, not only bear strained relationships with their counterparts but also are at risk of numerous health problems. Let us know about the health effects of sexual harassment:
The International Women’s Day echoes a word for transforming the lives of women with a bold determination not just on papers but in reality to support the women all around the globe. Many working women have sad tales to tell as they are exploited at a very high level, and they actually lead a stressful life in comparison to their male counterparts.
So, the spotlight this year is to fight against the injustice that most women face every day and to bring about a change that will be remembered for years and will outshine the lives of such women who devote themselves for the livelihood of their families.
Join a campaign, embrace your inner activist and empower the women in your life...
The #TimeisNow To:
In case you have a concern or query you can always consult an expert & get answers to your questions!
If a child is suffering from a congenital heart defect, it means that the child is born with a heart defect. Some of the heart problems are simple and don’t need treatment, while some are very complex and may need multiple surgeries depending on the prevailing heart condition.
Symptoms of Heart Defects-
The symptoms in children with serious heart defects depend on the type of congenital heart disease. Symptoms that a child can show are:
• Breathing problem while feeding the baby
• Frequent cough and cold
• Poor weight gain/weight loss
• Sweating over forehead during feeding
• Pale grey or bluish skin especially on crying
• Swelling in some areas like legs etc. in heart failure like situations
To mention a few the symptoms in children with less serious heart defects are not identified until childhood as in some cases, the child might not have the symptoms shown so early.
• Feeling short of breath during an activity
• Tiredness
• Faintness
• Swelling in some body parts
Causes of Heart Defects-
The heart of the foetus begins to take shape during the first six weeks of pregnancy. The heart also starts beating. During this time, the major blood vessels of the heart that carry blood back and forth also start developing.
At this point, the problem starts to occur and defects start developing in the heart of the child. Still, the doctors are not sure about the cause of the defects, but they believe its genetic.
Types of Heart Defects-
Some of the common heart defects include:
1. Holes in the Heart (ASD/VSD/PDA/AVSD)-
• Holes can be formed between the chambers or major blood vessels.
• Holes allow rich oxygen blood to mix up with poor oxygen blood.
2. Cyanotic heart diseases (TOF, TGA, Ebstein’s, etc)-
• In these heart diseases, child generally has bluish-blackish discoloration of fingers or lips
3. Obstructed Blood Flow (AS/PS/COA)-
• In this type of problem, the heart valves/heart vessels are narrow because of the defect; this causes the heart to pump harder.
• This can lead to enlargement of the heart. How to diagnose child heart diseases?
• Even in pregnancy, these heart diseases can be easily diagnosed by doing “Fetal Echocardiogram”. This test is like a routing ultrasound but focuses only on the fetal heart in detail. Fetal echo is generally done between 18-24 weeks but can be done in late pregnancy as well.
• After birth of the child, we need to do “Pediatric Echocardiogram” (just like an ultrasound). This is a non-invasive test with no pain to the child.
• By doing an echocardiogram, we can diagnose almost every child heart diseases.
• Sometimes, Cardiac cath study or CT angio of heart needs to be done for confirming the diagnosis.
Treatment-
1. Some heart defects do not need any treatment as they get cured itself within a span of time.
2. However, some are serious which need to be taken care of
3. Treatment can be done either by medicines or by doing angiographic procedure or by doing open heart surgeries
4. Now a day, majority of child heart diseases like ASD, VSD, PDA, Aortic or pulmonary stenosis or coarctation of aorta, excess fluid collection around heart can be managed in cath lab by doing angiography.
5. Other cardiac diseases like large VSD/PDA/ASD, TOF, TGA, Truncus, HLHS/Tricuspid Atresia needs open heart surgery.
6. Pediatric cardiac surgery or cath lab procedures are very safe now a day.
Precautions-
As the reason is still unknown for the defects in the heart, it is not possible to prevent these conditions. But there are some ways that can reduce the overall risk that builds heart disease. Some of them are:
• Get a Rubella Vaccine: A rubella infection at the time of the pregnancy can affect the child’s heart development. Women should get the vaccination before they try to conceive.
• Control Chronic Medical Conditions: If someone is suffering from diabetes, regular check-up of the blood sugar may reduce heart defects. If a person is suffering from any other disease, consult it with the doctor.
• Take Multivitamin with Folic Acid
VSD (a hole in the heart) refers to a congenital heart disease where a hole is formed in the ventricle septum i.e. wall between two lower chambers of the heart. As a result of this, blood from the left portion of the heart (left ventricle) crosses this hole and goes to right-sided heart that results in blood overflow to lungs.
VSD is one of the commonest child heart diseases that is seen at birth, but adults too may suffer from it following an acute heart attack.
What are the causes for Ventricular Septal Defect?
Congenital VSD occurs during heart development of the fetus. The heart develops from a huge tube, dividing into sections that, in turn, will become the chambers, walls and vessels of the heart. If something goes wrong during this process, a hole can develop in the ventricular septum.
Sometimes, VSD may be caused due to genetic and environmental factors. For instance, if you have a family history of genetic conditions like Down syndrome or congenital heart diseases, then your child may be at risk of developing a Ventricular Septal Defect.
Symptoms Indicating VSD-
The signs and symptoms of Ventricular Septal Defect vary depending on the size of the VSD. If the hole is small, child may be asymptotic. Children or young adults with small VSD only show signs of a heart murmur that is detected by their family physician.
A medium or large sized hole is likely to exhibit the following noticeable symptoms in children –
These symptoms indicate that the VSD will most likely not close by itself, and therefore, require urgent intervention. If left untreated, Ventricular Septal Defect may lead to further complications such as pulmonary hypertension, endocarditis, or Eisenmenger like situation.
How is VSD diagnosed?
Usually, VSD is detected within the first few weeks after the birth of the child during a routine check-up. The doctor can tell if your child has a hole in the heart by hearing a heart murmur, as oxygen-rich blood passes between the two ventricles.
Suspecting VSD, your doctor may refer you to a paediatric cardiologist, who will then perform a physical examination on your child, taking his/her medical history in consideration. The following tools are used to confirm the diagnosis –
What is the treatment?
Treatment of VSD depends on the size of the hole, and the age and weight of the child.
A small VSD with no significant symptoms mostly will require only follow-up. The child can do his/her activities without much fear.
Moderately sized VSD children are having poor weight gain and show signs of heart failure but less as compared to large VSD. These VSD needs to be followed up to 9-12 months of age and needs to close. The method of closure of moderate sized VSD depends on its location and size of VSD. Majority of moderate sized VSD can be closed by using a device in cath lab angiographically (VSD device closure non-surgically) or else by doing open heart surgery.
In a case of large VSD: Child shows signs of heart failure or in respiratory distress then first medical therapy in the form of diuretics are prescribed for decreasing the signs of heart failure. Then VSD surgical closure is advised preferably between 3-6 months of age.
Heart Surgery – This involves making an incision in the chest wall and maintaining circulation with the help of a lung-heart machine while closing the hole. The surgeon may either seam the hole or stitch a patch of material over it. The heart tissue will eventually heal over the stitches or patches. In about six months, the tissue will cover the hole completely.
Another treatment option is cardiac catheterization.
Cardiac Catheterization (Non-surgical closure of VSD)– The cardiologist inserts a catheter into the blood vessel in child legs that reach up to the heart. He/she then guides the tube to make measurements of blood pressure, blood flow, and level of oxygen in the chambers of the heart. A special implant known as a device is placed into the septal hole (VSD). The device flattens against the septum on both the sides to permanently heal and close the VSD.
Having your child diagnosed with a heart defect can be scary. However, consulting a paediatric cardiologist at the earliest can be helpful, as he will be familiar with Ventricular Septal Defect, and can tell you the best way to manage the condition.
Tetralogy of Fallot (TOF) is a commonest congenital cyanotic heart disease.
TOF is having a combination of large VSD with severe obstruction of blood flow to the lungs that result in bluish-black discoloration of lips and fingers due to flow of oxygen-deficit blood to the body parts.
The four defects that commonly associated with Tetralogy of Fallot (TOF) are –
In few cases, a child with TOF may also suffer from additional defects such as ASD (Atrial Septal Defect), additional VSDs, or abnormalities in the coronary arteries, etc.
What are the symptoms/signs due to TOF?
Symptoms due to TOF depend on how severely there is an obstruction of blood flow to the lungs. The most common sign in children with TOF is cyanosis – a tint of purple or blue on the lips, skin, and fingernails.
Other symptoms/signs to look out for include –
Complications of TOF-
If the symptoms go unnoticed and the condition is left untreated, your child may develop the following complications –
It is essential that you seek immediate treatment for your child. A Paediatric Cardiologist is ideally the person you should refer to.
Diagnosis of TOF-
TOF can be easily diagnosed by doing “Fetal Echocardiogram”. Fetal Echo needs to be done between 18-24 weeks of gestation preferably between 18-20 weeks of gestation.
“Pediatric Echocardiogram” is essential for making the diagnosis. An echocardiogram is a non-invasive test that needs to be done form chest of the child.
Other tests that can be supportive in making the diagnosis are ECG, chest X-ray.
Sometimes CT angio of heart needs to be done for defining the structure of heart when echocardiogram is inconclusive. Occasionally especially in older children or adolescents, Cardiac cath angiography has to be done when CT angio is less desirable.
Treatment for Tetralogy of Fallot (TOF)
Surgery is the definitive treatment option for managing TOF by open heart surgery.
The two surgical options are –
1. Palliative or Temporary Surgery – The procedure aims for improving the flow of blood to the lungs from a major blood vessel of the heart (Aorta). This is a preferred option when the baby is very blue and is having low weight to undergo complete repair.
This involves creating an artificial channel for the blood to reach the lungs by placing a shunt between a large artery and one of the pulmonary artery (either right or left) that diverges the blood from the aorta to the lungs for blood purification. This is known as BT shunt surgery. Sometimes when the size of pulmonary arteries is very small in size then central shunt needs to be done. This shunt is created between a large vessel of the heart (Aorta) and main vessel of the lung (Main pulmonary artery).
After doing this surgery, the child needs to be followed up at a regular interval till the complete repair is planned.
2. Complete Repair (Intra-cardiac repair of TOF) – Through this procedure, the surgeon enlarges the passage between the right ventricle and pulmonary artery so that blood flows to the lungs improves as well as surgeon closed the hole in heart (VSD) by putting a patch across it. (This abolishes overriding of the aorta as well).
Most children do well after complete surgery. Follow-up with Pediatric Cardiologist is required to ensure well being of the child.
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