1. Should we do treatment for precocious heart disease? Pan Xiangbin of the Department of Pediatric Cardiac Surgery at Beijing Fu Wai Hospital theoretically says that all diseases should be “treated”! And they should be detected and treated early, just like a needle in the arm, no one wants to wait until tomorrow to pull it out! Precardiac disease is like having a whip beating the heart, surgery only takes away the whip, but the wounds left by the previous whip will have to recover on their own, the thicker the whip (the larger the defect), the longer the whip (the later the treatment), the worse the patient’s recovery, so early treatment is needed. 2, since treatment is needed, why do some patients have to wait for a while before surgery? Because surgery is also a blow to the patient! The younger the child, the greater the risk of surgery, just like a punch on an adult, may only feel pain, but this punch on a 7 or 8 month old child, it is not good enough to kill him. So there’s only one principle to follow when it comes to surgery: the benefits must outweigh the risks! Now that we have methods without surgery, without radiation, without general anesthesia, the risk of treatment is greatly reduced, so a large number of patients can be operated on earlier, from about 3 years old to about 10 months! Thanks to technological advances, I can achieve early detection and early treatment.3. How to grasp the surgical indications?Do I need to treat a 4 mm atrial septal defect or a 2 mm ventricular septal defect? The common indication for surgery now is that interventional treatment is recommended for atrial septal defects over 5 mm and ventricular septal defects over 3 mm. However, please note the first point that patients below this standard are not recommended not to undergo surgery, but are recommended to be operated or observed. Observation is also risky. The second point is that we take a ruler to see how big 1 mm is. In fact, it is difficult to avoid an error of 1~2 mm in ultrasound measurement, which means that a 5 mm defect can be reported as 4 mm or 6 mm by different ultrasound doctors, not that we are not at a high level, but the current instruments can only do so. The third point, this surgical standard, in fact, is not accurate, why? Because everyone’s situation is different, just like the average height of Chinese men is 170 cm, is a 169 cm height a short person? The impact of heart defects on cardiac function, development, and pulmonary vascularity also varies from person to person. So the key is still the principle mentioned earlier, the benefit outweighs the risk to do the treatment! Of course, it also depends on what kind of surgery can be done, if minimally invasive interventions can be done, less traumatic, low risk, in line with the principle of benefit over risk can be done.4. Is there any risk in surgery? There is no minor surgery for heart surgery, if heart surgery can be done without life threatening, then there is no surgery that can be dangerous, the earth has long been full of people standing. Of course the risk is different for different surgical methods. The more we introduce the four treatments, the less traumatic and the less risky the method is. 5.No incision, no radiation, and no general anesthesia should be the best method! Can I choose this treatment method? Yes! But it is my choice, not yours. Because different patients are suitable for different methods, and everyone’s situation is different, just like buying shoes, buy the best-fitting shoes, not the prettiest ones! Doctors, as professionals, we know best what method is suitable for you. So the most important thing is to choose a good doctor. If this doctor will only do one surgical method, then there is no choice, there is only one pair of shoes in the shoe store, and it’s all about whether it fits or not. If the doctor will do all four methods, it is much better, just like fighting a war, soldiers will block, water to cover, the success rate of surgery greatly increased! Good! If you can’t block it, you can directly change to conventional surgery, just like going to buy a lottery ticket, as long as you enter the operating room, it is equivalent to winning five million, if you can make blocking surgery, it is equivalent to winning 10 million. It doesn’t matter if you don’t win $10 million, at least you can win $5 million, and if you don’t succeed in blocking it, you can change to conventional surgery, and you can cure your child’s disease if you go into the operating room only once. 7. Very dangerous! Is interventional therapy reliable? These doctors are mostly doctors who will not do interventions, the reason is simple, you know. Any kind of treatment has risks, this is to see a doctor not to travel, but the low risk of interventional treatment is supported by data, the so-called common complication rate in a few parts per million, almost the same as the probability of being hit by a car out of doors, do you never go out in your life? There are millions of interventional patients worldwide every year, one more is not much, one less is not less. As the so-called knowledge determines your fate, whether you have comprehensive information, whether you can make the right choice, of course, determines your fate.8. Is it okay to keep the blocker in the body for a long time? Too good! The blocker has been used for 30 years, you are not the first one to use it, and the majority of patients who have used it are doing well now. Why are they doing well? Because 6 months after the operation, the endothelium of the heart wraps the blocker, and the blocker is wrapped in the middle like a sandwich, not touching the flowing blood. 9.What if the blocker falls off? Surgical blocking method can hang a line on the blocker, even if the blocker falls off, the line pulling, the blocker will not run around, to buy time for surgery, like a ship under an anchor, the safety factor is greatly increased. 10.What about residual shunt? For large shunts, we can directly change to surgery. For residual shunts of 1~2 mm, parents can choose to change to surgery or to block and observe. For patients who choose to observe, 70% of them can grow well on their own within two years, because the blocker stimulates endothelial proliferation to eliminate the defect, even if some patients can’t grow 1~2 mm, they can’t reach the indication of surgery, just like this visit, if the ultrasound finds that the defect is 1~2 mm, it doesn’t need surgery. The review process is carried out to ensure that the patient’s postoperative recovery process is monitored timely and effectively. After one year of surgery, if the condition is stable, the patient will be reviewed once in 2~3 years. 12.What should I pay attention to during the observation period for patients who do not have surgery temporarily? Precocious babies in daily care must avoid as far as possible do not catch a cold, violent crying, these are not conducive to the child’s condition, in addition to observe whether the baby’s weight growth is normal, if the development is delayed, repeated colds and pneumonia, it is necessary to treat as soon as possible; generally do not recommend vaccination of precocious babies, precocious babies own resistance is poor, vaccination, increased risk of infection, six months after surgery can be normal vaccination. 13, myocarditis myocarditis refers to various causes of inflammatory lesions of the heart muscle, many myocarditis is caused by viral colds, this treatment process is also slow, like being stabbed by a knife, we use drugs to treat myocarditis, is in the treatment of this scar, the results of treatment varies from person to person, just like the knife stabbed deep, the effect is poor; knife stabbed shallow effect is good. The key thing is not to be stabbed by the knife again, that is, not to catch a cold again, to avoid myocarditis.14.How do I make an appointment for surgery? I am available Monday through Friday mornings and Thursday afternoons. You can make an appointment at the referral clinic to add a number, or come to me at the second consultation room on the second floor of the outpatient clinic at Fu Wai Hospital to add a number.