1.My child is diagnosed with “congenital heart disease, atrial septal defect”, is this heart disease serious?
A: Atrial septal defect is the simplest form of congenital heart disease, there are many ways to treat it, and it is basically the same as normal people after treatment, so there is no need to worry too much.
2.Can surgery cure a child with atrial septal defect at once?
A: Yes, the surgery can cure it at once, and if there is no complication after the surgery, it can be exactly the same as normal children.
3.Children suffering from atrial septal defect, is there a possibility of recurrence after surgery?
A: There is almost no possibility, there may be a residual shunt after surgery, meaning that there is still a residual defect in the atrial septum, but the incidence of this situation is extremely low, and the residual shunt of 5mm or less does not need to be dealt with at all, the child’s growth is no different from normal people.
4.The child was born 3 days ago and the atrial septal defect was found to be 3mm.
A: The child is still small and has the possibility of self-healing. Even if it cannot be self-healed, an atrial septal defect with a diameter of 5 mm or less will not affect the hemodynamics of the heart and does not require any treatment. In other words, although the child has atrial defect and murmur, it is no different from normal children in all aspects and does not need to do any restriction or special treatment.
5.The atrial septal defect of 3mm was detected at birth, and now the child is 3 years old, the atrial septal defect is still 3mm, do I need surgery?
A: No. Atrial septal defects of 5mm or less have no hemodynamic significance and are the same as normal people, so they do not need surgical treatment.
6.A septal defect of 6mm was found after the child was born. Will the atrial defect become larger as the child grows and the heart grows?
A: This situation is possible. 5mm or more atrial septal defect may grow with the growth of the child’s heart, and may also gradually heal, this individual difference is very large, it is difficult to say how probable, in this case we recommend that you regularly review the ultrasound, dynamic observation of the child’s growth and development, selective intervention.
7.The child is 6 months old and an atrial septal defect of 8mm has been detected, do you need to operate immediately?
A: Generally, it is not necessary. Although an atrial septal defect of 5-10mm has a certain impact on the hemodynamics of the child, the impact is very small and will not affect the growth and development of the child, so you can wait until the child grows up to 3 years old to do interventional blocking surgery. This avoids the risk of surgery and does not leave a surgical scar. Of course, during the waiting process, it is necessary to review the ultrasound once every six months to a year, and at the same time observe the child’s growth and development and immunity, whether it is particularly easy to catch a cold and pneumonia, if the above two conditions exist, it is necessary to operate or intervene earlier.
8.The child is 10 months old and the atrial septal defect of 15mm is detected, is it possible to heal by itself?
A: Generally, the possibility of self-healing of atrial septal defect above 10mm is very small and almost impossible. If the child is well developed and asymptomatic at this age, you can continue to observe and intervene at the age of 3-6 years.
9.The child is 10 months old and found to have an atrial septal defect of 15mm, he always has a cold and pneumonia, do you need to operate immediately?
A: If the child is obviously more prone to cold and pneumonia than children of the same age, and the parents are afraid that the child will always suffer from life, and if the atrial septal defect leads to tricuspid valve insufficiency or high pulmonary artery pressure, surgery should be considered.
10.The child is 10 months old and has an atrial septal defect of 15mm, which is slow in development.
A: This condition is generally due to the large atrial septal defect, resulting in a large left-to-right shunt blood flow, which will affect the child’s growth and development. Of course, this surgery is not an emergency surgery, it is an elective surgery, that is, wait for six months and a year and then do it again will not be too big a problem.
11.Will an atrial septal defect of less than 5mm affect the child’s future activity if it is not treated?
A: Many parents are concerned about such a problem. They feel that if the heart is different from normal, the child is different from others. In fact, there is no need to worry. The function of the human heart is to pump enough arterial blood to all parts of the body and to admit venous blood from all organs of the body, and then pump it to the lungs for oxygenation. A septal defect of less than 5 mm has a very small fractional flow and does not affect the function of the heart much, so functionally it is no different from a normal person. So there is no problem to go dancing, engage in sports activities, etc.
12.The child’s septal defect is septal type, can we do interventional blocking treatment?
A: In this case, it depends on the specific type of septal defect. If the septal defect is far away, it is very unlikely to be blocked. If there are one or two small septal defects in the vicinity of a large atrial defect, then it is possible to seal it. In general, the success rate of septal atrial defect sealing is lower than that of the central type, and there is a higher possibility of interventional sealing followed by unsuccessful conversion to conventional surgical treatment. Therefore, if parents are not very reluctant to surgical procedures, it is recommended that you do not choose this treatment for your child, who may suffer twice.
13.The girl’s atrial septal defect is less than 5mm, the doctor suggested that it does not need to be treated, will it affect pregnancy when she grows up without surgery?
A: No, the answer to question 11 has already explained why a small septal defect will not affect the child’s development and future activities, and the same applies to pregnancy. Patients with heart disease cannot become pregnant because the weight of the pregnant woman increases during pregnancy and the fetus needs the mother’s circulation to provide it, which can aggravate the compliance of the pregnant woman’s heart, including all other organs, and if the heart has a hemodynamic defect, it may not tolerate it and lead to heart failure. However, small atrial septal defects have very little effect on the heart and are almost negligible, so there is no need to worry.
14.Will a child with an atrial septal defect be exactly the same as a normal child after surgery?
A: If there are no complications related to the surgery, the child will be exactly the same as a normal child except for a wound.
15.How old does a child with atrial septal defect who wants to have minimally invasive interventional blocking treatment have to be before he can have it?
A: There are two types of minimally invasive interventional blocking, one is percutaneous intervention and the other is transthoracic intervention. The former is through the femoral artery at the root of the thigh, which can only be done when the child is 3 years old or above 12 kg; the latter is a small incision in the anterior chest, which has a wider indication and can be done for children without special circumstances.
16.Can a child with two atrial septal defects be treated in one operation?
A: Whether there are several atrial septal defects, or combined with some other congenital heart disease simple malformations (such as arteriovenous ductus arteriosus or ventricular septal defect), surgery can be a single radical treatment.
17.Can a child with atrial septal defect combined with ventricular septal defect be cured in one operation?
A: Yes, heart surgery requires incision of the heart under extracorporeal circulation, which will fully expose all parts of the heart, and the surgeon will explore all parts and correct any abnormal heart deformities. This is the great advantage of surgery, the most exact, complete and thorough treatment of precordial disease.
18.Is it possible to do interventional blocking treatment for a child who does not have a stump on the lower edge of the atrial septal defect?
A: At present, it is not possible. The blocking treatment of atrial septal defect depends on the edge of the septum around the atrial septal defect catching the blocking umbrella, and the two ends of the blocking umbrella sandwiching the defect in the middle and blocking the defect. If there is no residual edge around the septal defect at any time, blocking surgery is not recommended.
19.My child has recently caught a cold, can I have surgery?
A: Surgery is not recommended. The atrial septal defect would have caused a left-to-right shunt in the heart, with more blood flow in the right heart system and more blood flowing into the lung tissue. The lungs will exude when you have a cold, increasing the lung resistance and affecting the function of the lungs, so the cold will aggravate the damage to the lungs from the surgery itself, which is extremely detrimental to recovery. Especially for children aged one year or older, surgery is contraindicated when they have cold symptoms.
20.The child has an atrial septal defect and wants to have surgery, but the child has recently been burned and the wound has not completely healed, so can he have surgery?
A: If the wound is not healed, it is not recommended to do surgery. Because the surgery requires extracorporeal circulation, it will give the child systemic heparinization, so the child’s coagulation function will be very poor, the original wound on the body have the possibility of re-bleeding, but also on the child’s post-operative care will increase the difficulty, increasing the risk of wound infection. Moreover, atrial septal defect repair is not an emergency surgery, so it is possible to wait for the child’s wound to heal completely before surgery.
21.My child has an atrial septal defect, but he/she is allergic to many foods, will it affect the surgery?
A: It is not an absolute contraindication to surgery. However, for children with allergies, more drugs will be used during and after the surgery, and the chances of his allergy to drugs are higher than those of children without allergy history.
22.Can a child with iron deficiency anemia and low preoperative hemoglobin level undergo atrial septal defect repair surgery?
A: Most of these cases are possible. The anesthesia and in vitro surgeon will adjust the amount of blood products according to the overall condition of the child during the surgery, so that the child can reach a more suitable balance for the surgery. However, if the anemia is very serious, for example, the hemoglobin concentration is below 6g/L, the child’s nutritional status is very poor, and there may be potential problems with other organ functions, so the child may not be able to tolerate the heart surgery.
23.Can a child with atrial septal defect combined with laryngeal osteochondrosis be treated surgically?
A: Children with combined laryngeal osteochondrosis can usually heal themselves within two years of age without surgery. However, once combined with cardiac surgery, the recovery of children with laryngeal osteochondrosis is significantly affected by tracheal intubation, delaying the removal of tracheal intubation or making it impossible to remove it, which requires further consultation in pediatric respiratory specialists. Therefore, if the atrial defect is not very large and has little impact on the heart function, surgical treatment can be considered after the age of 2 years.
24.Can a child with atrial septal defect combined with tracheal stenosis undergo heart surgery?
A: Children with tracheal stenosis often have symptoms of respiratory distress, and atrial septal defect is not an emergency surgery, it is recommended to treat tracheal stenosis first before surgery.
25.Is atrial septal defect repair a minor surgery? Is the success rate of surgery high?
A: Cardiac surgery is the most important organ of the human body, the heart, so cardiac surgery is the most advanced surgery. In cardiac surgery, atrial septal defect is the simplest surgery, and the success rate is very high, close to 99.9%.
26.What is the best age to operate on a child with atrial septal defect?
A: This will vary from person to person. You also need to refer to the surgical method you choose. If surgery is done, if the child does not have heart function related problems, it is more appropriate to wait until the age of 2-5.
27.What will happen if my child has an atrial septal defect without surgery?
A: An atrial defect of <5mm is hemodynamically indistinguishable from a normal person and can be operated without surgery. However, a large atrial septal defect will lead to a continuous left-to-right shunt, which in short means that the child's heart load will increase and the pulmonary artery pressure will increase, which may induce heart failure later when performing heavy physical labor or when a woman is pregnant, which will greatly affect the patient's quality of life or even endanger her life.
28.Do I need general anesthesia for atrial septal defect repair surgery?
A: Yes, and the anesthesia for cardiac surgery is deep, which helps to reduce the load on the heart.
29.Will general anesthesia have any effect on the child’s intelligence?
A: There are no scientific reports in the literature to support this, so in the doctor’s opinion, general anesthesia will not have any effect on the intellectual development of the child.
30.Is there any difference between minimally invasive lateral incision and small axillary incision surgery for atrial septal defect repair?
A: Actually, these are two names for one type of surgery. The surgical operation and risks are the same and there is no difference.
31. Is it riskier to do atrial defect repair with a lateral incision than with a median incision?
A: Yes. This is because the right side incision can only expose the right side of the heart and is operated in a distant position. The risks are as follows: the heart cannot be fully exposed, which makes it difficult to rescue in case of any accident; the operation distance is far, which requires a high level of surgeon’s surgical skills; the intracardiac malformation cannot be fully explored, and if the disease is not consistent with the preoperative diagnosis, it is difficult to be detected by intraoperative exploration. However, in a well-established cardiac surgery center such as ours, the increased risk of a lateral incision over a median incision is negligible relative to its benefits.
32.Will a child with an atrial septal defect, prepared for surgery with a lateral incision, affect the development of the child’s breast in the future?
A: The possibility is there. But mature cardiac surgeons try to avoid it and the incidence is very low.
33.The child had a median incision atrial defect repair, and the sternum was fixed with a wire, do you need to remove it later?
A: If there is no wire fracture after the severed head damage to the surrounding important tissues and organs, no wire allergy, generally do not need to be removed.
34.Will the steel wire that fixes the sternum after the median incision surgery affect the future life?
A: Generally, it will not. There is no difference between patients and normal people in terms of activities and life.
35.Is it possible to have a pectus excavatum or funnel chest after median incision surgery?
A: There is this possibility. So after surgery, we usually use a chicken chest treatment device to prevent this kind of situation. However, younger children have softer sternum and are more likely to develop this condition. Once it occurs, you need to go to pediatric thoracic surgery for further treatment.
36.How to prevent the appearance of pectus excavatum or funnel chest after surgery?
A: According to the physician’s request, you can wear a chicken chest treatment device and pay attention to the child’s calcium and other micronutrient supplementation to avoid the appearance.
37.What kind of material is used to repair the atrial septal defect?
A: There are generally two types, autologous pericardial piece and polyester piece. Autologous pericardial piece is the autologous tissue taken from the child’s pericardium.
38. The pericardium is used to repair the atrial septal defect. Will the lack of this pericardium affect the child in any way?
A: No, it will not.
39.What do I need to pay attention to when my child has an atrial septal defect and wants to be treated surgically when he is older?
A: Pay attention to the prevention of colds. In addition, regular review is needed, usually once a year, to avoid undetectable changes and losing a better time for surgery.
40.My child has an atrial septal defect and wants to do blocking treatment. If the interventional blocking treatment is unsuccessful, can we still do surgery?
A: Yes, you can. Surgical procedures can solve all problems. However, it is difficult to do minimally invasive surgery for children with failed blocking in general.
41.What are the advantages of interventional blocking treatment for atrial septal defect?
A: Minimally invasive, the procedure does not require open chest, no surgical incision, no extracorporeal circulation, short anesthesia time, 1-3 days after placing the blocking umbrella can be discharged, the least trauma, the fastest recovery; aesthetic, only a small puncture point at the root of the thigh, basically no scar.
42.What are the advantages of surgical treatment of atrial septal defect?
Answer: ①. The widest scope of application. Regardless of age, location of ventricular septal defect and whether it is combined with other deformities such as tricuspid valve insufficiency, all can be treated by this operation; ②. The long-term effect of the operation is most definite. The procedure has a history of 70 years, and a large sample of evidence-based medical evidence is perfect for the long term after surgery. The complication rate is low. With the rapid development of anesthesia and extracorporeal circulation technology in recent years, the impact of extracorporeal circulation and anesthesia on children in simple precordial surgery has been perfected to be negligible, and the risk of surgery is less than one in a thousand; it is much higher than all kinds of blocking surgery. ④No radiation and contrast damage; ⑤No foreign body in the body, no need for anticoagulation treatment, and no hidden danger of affecting life in the future. How long does it take for a child to fully recover after atrial septal defect surgery?
43. How long after the atrial septal defect repair surgery can vaccination be performed?
A: More than six months.
44.Do I need to take medicine for a long time after atrial septal defect repair surgery?
A: No, it is not necessary. Generally, you only need to eat cardiac diuretic drugs for one month.
45.How many days does it take for a child to be discharged from the hospital after atrial septal defect repair?
A: According to the recovery of the child varies from person to person, generally 5-7 days.
46.How many days after the operation can the child with atrial septal defect have the stitches removed?
A: Seven days after surgery.
47.When can my child take a bath after the atrial septal defect repair and the stitches have been removed?
A: After all the scabs on the wound fall off naturally, you can take a bath. Avoid getting water on the wound before that.
48.After the surgery, can I take calcium medication at the same time when my child is taking cardiotonic, diuretic and potassium medication?
A: Generally, when taking digoxin orally, it is not recommended to take calcium supplements at the same time. You can take it after stopping the medication.
49.Children are discharged from the hospital after surgery, but they are still taking oral cardiac diuretic and potassium supplements, and they have symptoms such as cold or diarrhea.
A: Generally, it is possible. It is better to go to a pediatric specialist to prescribe medication.
50.After the surgery, will the scar of the surgery become bigger as the child grows?
A: Yes, it will. The size and prominence of the scar will change. If you are not satisfied with the scar in the future, you can go to the scar department of the plastic surgery hospital for treatment.