-Contributed by Navaneeth R.
‘Heart hole ‘ is not a phrase that’s taken lightly by anyone, especially when given as a diagnosis. Despite the concerning nature of the name, they are the most common type of congenital heart disease, i.e., the defects in the structure or function of the heart by birth. A heart hole may be a VSD (ventricular septal defect) or an ASD (Atrial septal defect). Traditionally, any defect in heart used to be repaired by open heart surgery. But in the past few decades, interventional cardiology as a branch has evolved tremendously so that many procedures can be done without open heart surgery. Here we will see in brief some of the minimally invasive heart hole treatment without surgery.
Types of Minimally Invasive Procedures
The single most important procedure for closure of septal defects is percutaneous closure or trans-catheter device closure. This is the most widely used non-surgical technique. In this method, a major artery or vein like the femoral artery/vein is accessed and a thin flexible wire called a catheter is advanced through it under x ray guidance. An echocardiography may be performed during the procedure to visualize the heart in real time. Through the catheter, an occluder device is deployed that will result in the closure of the hole. This is a well tolerated procedure with excellent outcomes on par with surgical repair. But not all patients are ideal candidates for this procedure. Only patients with certain subtypes of septal defects (e.g.: ostium secundum ASD) with suitable anatomy are ideal candidates.
Another type of minimally invasive method is called Minimally invasive cardiac surgery or MICS. Although it is a type of surgery, this method avoids a large incision and instead, surgery is performed through small incisions in the chest leading to better cosmetic outcomes and faster recovery without compromising efficacy. Children with larger defects not suitable for device closure can opt for this method. In some specialized centres, MICS can be done with robotic assistance, further increasing the precision of the surgery.
What are the benefits of minimally invasive procedures?
There are numerous benefits for minimally invasive procedures. The aim of any hole in heart treatment is to correct the defect with minimal complications. Compared to the traditional open-heart surgery, minimally invasive methods ensure same level of correction with lesser chance of complications in the long run. Apart from that, these procedures significantly reduce hospital stay from few weeks to few days. This reduces the chance of hospital acquired infections and patients can be discharged within 24-48 hours. For open heart surgery, usually a cardio- pulmonary bypass is required where chances of infection and other systemic complications are high. Along with that, a large incision on the chest further complicates the recovery phase.
All of these can be avoided with minimally invasive methods. Despite the clear advantages, these methods are not completely devoid of risks. As for any procedures, complications may arise and it includes device related complications such as device embolization where the implanted device may dislodge and migrate within the heart or the great vessels, a potential life-threatening complication. The incidence rate is very less as this complication can be avoided by careful patient selection, precise imaging for accurate size determination and proper technique of implantation. Sometimes the device may not fit properly and there can be residual leakage. Other complications include arrhythmias or irregular rhythm in the heart and valvular damage that may occur while implanting the device. But these are rare scenarios and, in most cases, success is guaranteed with no long-term complications.
Outro
It is now clear that the options are plenty for hole in the heart treatment. But access for these treatment modalities still remain a challenge for many families in India. Organizations like Genesis Foundation are working over the years to bridge this gap and make child heart treatment a reality for thousands of children with congenital heart defects (CHDs). Your contribution to this cause can make a huge difference in their life. Remember, these advancements discussed above are only meaningful if real children benefit from it!
To make a donation for poor children in India, click here: https://www.genesis-foundation.net/donate. To more about how to donate to charity in India, visit Genesis Foundation’s website: https://www.genesis-foundation.net/.
To become a part of their fundraising event- Kasauli Rhythm and Blues festival 2027, one of the top music festivals in India, call at +91 96506 03438 or drop an e-mail at contactus@genesis-foundation.net.
