1. What is congenital heart disease? Congenital heart disease is a cardiovascular disease that is present from birth, including: atrial septal defect, ventricular septal defect, patent ductus arteriosus, and tetralogy of Fallot. Kailun Zhang, Department of Cardiac Surgery, Wuhan Union Medical College Hospital
2. How to classify? Classification: 1) Non-cyanotic precardiac disease: Children usually do not have cyanotic manifestations and are usually seen during physical examination when a heart murmur is detected. For example, arteriovenous ductus arteriosus, atrial and ventricular septal defects, partial pulmonary venous malformation drainage, etc. 2) Cyanotic precocious heart disease: children with cyanosis appear immediately after birth or gradually afterwards.
3) Is congenital heart disease hereditary? Congenital heart disease has certain genetic factors, but genetic factors do not necessarily develop, it is also related to environmental factors, early pregnancy infection, medication, radiation exposure and other factors.
4. How to take care of congenital heart disease before surgery? Pre-operative: 1) Combined with other diseases: such as liver and kidney function damage, acute infectious diseases, infectious rash, etc. If abnormalities are found, you should seek medical attention and go to the hospital for cardiac surgery after cure. 2) Prevent respiratory infections: children with congenital heart disease such as arteriovenous ductus arteriosus, atrial and ventricular septal defects should prevent pulmonary infections. (3) Children with cyanotic congenital heart disease: control the child’s activity, rest more, drink more water, and avoid strenuous exercise and crying.
5) How to take care of the patient after surgery? Postoperative care: 1) Prevent infection after surgery 2) Limit strenuous activities and heavy physical labor for three to six months 3) Eat a general diet, semi-liquid, high protein, low salt, high fiber diet, small and frequent meals, do not overeat. In particular, control the amount of fluid intake (20-40ml/hour for children aged 1-5 years, 40-80ml/hour for children aged 5-10 years, 80-120ml/hour for children aged 10-14 years). 4) Respect the doctor’s advice to take medication on time, do not stop medication at will, increase or decrease the amount of medication. 5.
6. Post-operative examination? Post-operative review should follow the doctor’s advice. Generally speaking, ECG, chest X-ray, cardiac ultrasound, etc. should be reviewed 3-6 months after surgery. If there is no abnormality, it will be rechecked after one year, and after 2 years, there is no need to recheck if there is no abnormality.
7. How to regulate nutrition? The diet should be a general diet, semi-liquid, high protein, low salt and high fiber diet, small and frequent meals, do not overeat, limit smoking, alcohol, tea, coffee and stimulating food.
8. When should I take vaccination after surgery? Generally, vaccination can be given to children who have basically recovered their mental and physical strength after surgery (3-6 months), have no immune deficiency and are not accompanied by other diseases.
9. What kinds of treatment methods are available for precardiac disease? What are the differences? There are two types of treatment for congenital heart disease: surgical treatment and interventional treatment. Surgical treatment is the main treatment modality, which is useful for all kinds of simple congenital heart diseases (such as ventricular septal defect, atrial septal defect, arteriovenous ductus arteriosus, etc.) and complex congenital heart diseases (such as congenital heart disease with pulmonary hypertension, tetralogy of Fallot and other heart diseases with cyanosis). Interventional therapy is a new treatment method developed in recent years, mainly for children with unclosed ductus arteriosus, atrial septal defect and partial ventricular septal defect that are not combined with other anomalies requiring surgical correction. The difference between the two is that surgical treatment has a wider scope of application and can cure all kinds of simple and complex congenital heart diseases, but it is traumatic and has a relatively long recovery time after surgery, and also leaves surgical scars that affect the aesthetics. Interventional treatment is narrower in scope and more expensive, but it is non-invasive, with quick recovery and no surgical scars.
10. What is the optimal time for treatment of precordial disease? The best time for surgery depends on a number of factors, including the complexity of the congenital malformation, the age and weight of the child, and the general development and nutritional status of the child. Generally, for simple congenital heart, it is recommended to be 1 – 5 years old, because too young, low weight, poor systemic development and nutritional status will increase the risk of surgery; too old, the heart will compensate for the increase in size, and some may even have increased pulmonary artery pressure, which will also increase the difficulty of surgery and longer recovery time after surgery. For combined pulmonary hypertension, congenital malformations that are serious and affect growth and development, malformations that threaten the life of the child, and complex malformations that require staged surgery, the earlier the surgery the better, regardless of age.
11. Is there any possibility of congenital heart healing? Generally speaking, precordial heart disease cannot heal on its own and needs to be cured by surgery or interventional methods. However, for ventricular or atrial defects with a caliber of less than 0.5 cm, no treatment is needed, as it will not adversely affect the heart function and growth of the child. However, due to the presence of heart murmur in children, which has certain impact on future education, employment and marriage, and the surgery is now very mature, some parents still choose surgery due to these social factors. There are also some small defects, such as ventricular defects in the sub-stem area, which are less than 0.5 cm due to their proximity to the aortic valve, and they also need active surgical treatment. Surgery is recommended for children with defects larger than 0.5 cm in caliber.
12. What is the general length of stay in our hospital for congenital heart disease? The general hospitalization time for simple congenital heart disease in our hospital is about 10-13 days, which consists of three stages: preparation before surgery, surgery and postoperative recovery after admission. For children with combined pulmonary hypertension, some of them need to undergo right heart catheterization and dilation treatment before surgery, and for children with complex congenital heart disease such as Fallot’s tetralogy, some of them need to undergo selective cardiovascular imaging before surgery, and the recovery time after surgery is a little longer, so the total hospital stay may be extended accordingly. Other usual parental concerns.
13. What is congenital cosmetic surgery? A cosmetic precordial surgery is a lateral open heart (axillary open heart). Lateral opening is suitable for children with atrial septal defect, arteriovenous ductus arteriosus and partial ventricular septal defect. The sternum needs to be incised for median opening, while the sternum does not need to be incised for lateral opening, so the damage to the thorax is small and the wound is on the side, which does not affect the aesthetics.
14. Will I be less susceptible to colds after surgery? It is still easy to catch a cold within six months after the surgery, which is caused by the decrease of children’s resistance after the surgery. After six months, the number of colds will be significantly less than before the surgery.
15. Is it necessary to remove the “wire” that fixes the thorax after surgery? “No, the wire does not need to be removed, it will not have any effect on the child’s body and growth.