With advances in medicine, the timing of surgery for congenital heart disease cannot be determined by age or tolerance of surgery. In general, congenital heart disease rarely recovers spontaneously, and most of them should be treated with surgery early. In some cases, the complications increase with age and the condition gets progressively worse. Even if there are no symptoms, do not hesitate. If left untreated, some complications are endocarditis, embolism, bleeding, hypertension and life-threatening. Therefore, the best time for surgery for precordial disease should be based on the specific condition of the child. Xiao Shiliang, Department of Cardiac Surgery, Wuhan Union Hospital
The most common congenital heart diseases ventricular septal defect, atrial septal defect, patent ductus arteriosus, pulmonary artery stenosis, etc. The timing of their surgery depends on the size of the defect, such as large defect, large fractional flow, severe pulmonary congestion, often accompanied by heart failure, pneumonia and other complications, and heavy pulmonary hypertension, should be operated early, and the surgery can be performed in infancy (within 1 year) or even during the neonatal period.
For some children who are not detected in infancy, or detected without treatment, after preschool age is the last favorable time for surgery. For simple heart diseases such as ventricular septal defect, atrial septal defect, arteriovenous ductus arteriosus, and pulmonary stenosis, surgical correction can be very satisfactory if performed when there is no pulmonary hypertension or other lesions. Moreover, the risks and costs of surgery are relatively low. For both families and society, timely and effective surgical correction of this type of simple precordial disease is the most economical and appropriate.
However, at the same time, we also see in clinical practice that a considerable number of children with this type of simple heart disease are forced to give up the surgery at the last favorable time because they cannot afford the treatment cost of tens of thousands of dollars even if they are found before school age. Especially for patients from rural areas, tens of thousands of dollars can be a lifetime savings for their families. Some patients even begin to come to the hospital for surgery only after they have missed the best time for surgery because they have developed obvious symptoms. At this point, neither the risks nor the costs of surgery are the same as they were at the beginning. Moreover, there are some patients who are too sick or unable to operate, or have poor post-operative recovery, or even do not survive the surgery, resulting in the loss of life and money, which is a tragedy for both the family and society.
The cardiovascular surgery department of Wuhan Union Hospital has a long history and strong strength. Its technical level of treatment and service quality are second to none in the country. Over the years, a large number of complex precardiac, macrovascular diseases, severe valvular lesions and serious complications of precardiac disease have been admitted to the Union Hospital, which is among the top in the nationwide category, both in terms of the number of patients and the difficulty of treating the disease. Faced with the limitation of ward size and the constant flow of patients, the experts and professors of cardiac surgery always believe that we should not only make achievements in the difficult diseases that can reflect our high technical level, but more importantly, we should have a sense of social responsibility as doctors, so that those patients with simple heart disease can be cured at the best time and with the least cost. For those patients whose families are in difficulty, we should help them within our ability so that they will not have lifelong regrets and bring heavy burden to the whole family because of less that 10 or 20 thousand Yuan. For this reason, every year, the chief professors of the Department of Cardiac Surgery have repeatedly reported to the higher authorities of the hospital, applying for communication and requesting for help to carry out preferential activities for these patients, so that they can have surgery as early as possible under the conditions they can afford, and lay the foundation for a healthy work and life in the future. 2009, the Department of Cardiac Surgery once again fought for a subsidy from the hospital to treat simple ventricular septal defect at a lump sum price of 12,000 yuan. In 2009, the Department of Cardiac Surgery again obtained a subsidy from the hospital to treat simple ventricular septal defect, atrial septal defect, patent ductus arteriosus, pulmonary artery stenosis and other precordial diseases at a cost of 12,000 RMB. It opens the door to happiness for the future life of these patients.