Every year 12 thousand congenital heart disease baby It is born. Today, even the most severe congenital heart diseases can be successfully treated with interventional cardiologic methods and surgeries. Congenital heart disease consanguineous marriage, radiation, infections in early pregnancy, chromosomal abnormalities, maternal diabetes during pregnancy Factors such as alcohol use are reported to be effective.
According to statistics, 8 out of every 1000 babies are born with heart diseases. The abnormalities in the hearts of 12,000 babies born every year can be corrected by surgery, albeit very severe. The cause of 90% of congenital heart diseases, such as holes in the heart, stenosis in the valves, and incomplete development of the valves and chambers, is not completely clear. However, factors such as consanguineous marriage, radiation, infections in the early stages of pregnancy, chromosomal abnormalities, maternal diabetes and alcohol use during pregnancy are thought to have an effect on the baby's heart health.
Acibadem Hospital Kadikoy Cardiovascular Surgery Department. Dr. Tayyar Sarıoğlu says that early intervention is of great importance in the treatment of heart diseases in children, and thanks to the developing surgical methods, anesthesia techniques and intensive care services, even 1-day, 2-weight-weight babies can be operated successfully: “Congenital heart disease, It occurs due to the developmental disorder in the womb of the heart and the blood vessels that come out of or from the heart. Nowadays, the rate of successful treatment of these problems is high and the chances of these children to continue their lives as healthy adults in the future are increasing. As a result of advances in diagnostic methods and cardiac surgery, even those diseases that were previously described as hopeless can now be cured.
Congenital heart disease is a rare disease and the cause of the disease is unknown in most of them. It is unnecessary for the family to think that they have a misdemeanor when the child is born with a heart anomaly. Some viral diseases rarely cause heart defects. for example during pregnancy Rubella disease can prevent the development of the heart of the unborn baby and may cause some developmental defects. In some cases, heredity may be held responsible for the development of congenital heart disease. Congenital heart disease is very rare in more than one child in the same family. Down syndrome In some diseases such as heart, many abnormalities can be seen in many organs, including the heart. Some medications used during pregnancy, alcohol, drugs, x-ray exposure, consanguineous marriage, maternal diabetic may increase the risk of heart failure in the baby. "
Pediatric cardiologists deal with children's heart diseases. Stating that the pediatric cardiologist will first take the patient's history and perform the necessary tests after the physical examination. Acıbadem Hospital Bakırköy Pediatric Cardiology Specialist Dr. Contact Ayşe directly speaks:
Echocardiography: X-ray examination, electrocardiography (ECG), echocardiography or some blood tests may be requested after the examination. ECG is a painless test for the child. Because the ECG device does not give any electrical current to the child, it only detects weak electrical currents in the heart of your child and takes a zigzag record on the ECG paper. This recorded heart beat is called electrocardiography (ECG). Echocardiography examination is also a needle-free examination. In this examination, moving images of the heart are observed using sound waves outside the chest. In the meantime, the blood flow in the heart and vessels is measured by using sound waves using the Doppler technique. Using these two techniques, the cardiologist learns about the structure and function of the heart. With this examination, a very large portion of heart anomalies can be diagnosed.
Fetal echocardiography: It is a test that can be applied starting from the 16th week of pregnancy and does not harm the baby and the mother, and it is used to examine the structure and functions of the heart and vessels of the baby in the womb. With this examination, it is possible to determine whether your baby has a heart anomaly.
Chest X-ray: The pediatric cardiologist has knowledge about the size and shape of the child's heart and lung. The radiation of the chest film and the area is very low and does not have any side effects
Cardiac catheterization and angiocardiography: It is an advanced examination performed with the help of a highly developed X-ray machine. Usually, it is performed by means of a thin tube (catheter) which is inserted into the veins from the groin area, and the balls are pushed to the heart. During angiography, a special dye that is visible through the catheter into the vessels and the chambers of the heart is x-rayed. After the dye is applied, the x-ray film is recorded. This test is called angiocardiography to diagnose heart defect.
Cardiac electrophysiology: Disorders of the heart rhythm seen in children sometimes occur due to congenital causes and sometimes after cardiac surgery. The cause and type of disorders in heart rhythm can be determined by a special examination such as heart catheterization. During this study called cardiac electrophysiology, if necessary, treatment of the focus and abnormal conduction pathways that cause irregular rhythm can be performed with a method called ablation (burning with radiofrequency waves).
Cardiac MRI Although all these tests are performed in some cases, heart disease may not be fully diagnosed. To determine exactly what the problem is in these children, some further investigations such as MR (magnetic resonance) or MR angiography may be necessary. These examinations give very good information about the large vessels and lung vein structures that come out of the heart and return to the heart.
Some of the children with heart anomalies are treated with drugs. In addition, the child will have surgery before and after the operation may need medical treatment. Drug treatments help the heart to work.
Regarding pediatric heart diseases in need of medical treatment. Dr. Ayşe Sarıoğlu speaks:
Sal Congenital Heart Failure: It is a condition encountered in many heart anomalies. Since the heart pump cannot function sufficiently strongly, fluid accumulates in the lungs and other organs and causes edema (swelling). Children with congenital heart failure get tired quickly, have a fast and distressed breathing. Diuretic so-called diuretic drugs may help to remove excess fluid, while a low-salt diet may be necessary. Digoxin and some other drugs may strengthen the contraction of the heart. Feeding of babies with congestive heart failure is often problematic.
Heart Rhythm Problems: Depending on the age of the child, the heart beats 60-150 times per minute. Sometimes the heartbeat can be very fast (tachycardia). This condition may not always develop due to congenital heart disease. It may be necessary to use medication to lower the heart rate to normal. The child's heart beat may be very slow (bradycardia). This may cause a decrease in the blood pumping function of the heart. Bradycardia is usually congenital, but rarely occurs after surgery. A device that alerts the heart to some children to keep the heart at normal speed. (pacemaker) may need to be installed. There may be irregularities in the heartbeat (arrhythmia) due to congenital heart disease. This may occur after surgery and may require treatment depending on the type of irregular heart rhythm.
In some heart anomalies, the mixing of dirty and clean blood is necessary for the baby to survive. In this case, especially in newborn babies, the catheter with a balloon at the end is entered into the heart and a hole is opened between the upper chambers of the heart. Some heart valves that are narrow are opened with balloons during catheterization and treated without surgery.
Professor Dr. Ayşe Sarıoğlu, “Some heart holes and non-occluded vascular openings can be closed during catheterization. In children with some rhythm problems, foci that cause this problem can be found by heart catheterization and the rhythm problem can be treated by kat ablation esnasında method during catheterization. ”
Congenital heart disease is determined as a result of the necessary examination after the surgery is decided. The decision-making team includes pediatric cardiologists and cardiovascular surgeons. The doctors evaluate the tests together and decide whether the child will benefit from the surgery. Professor Dr. Tayyar Sarıoğlu gives the following information about the operation:
Unuz Your child is usually hospitalized shortly before surgery. The average hospital stay is 5 to 10 days. This period may be extended under certain conditions. As long as you are in the hospital, you will be provided with their favorite toys and clothes specially designed for young children. We try to make the child feel at home as much as possible. Heart surgeries are performed by a team of doctors, technicians and nurses who specialize in this field. While the surgeon concentrates on the surgery, others are interested in devices that provide the patient's blood circulation, respiration and other vital functions.
Heart-lung machine: Heart-lung machine is used in open heart surgery. This device disables the lungs and heart, allowing oxygenation of the blood and pumping blood into the body. Thus, the heart can be opened and repaired safely. With this method, the surgeon can easily see and correct the heart and heart defects. At the end of the operation, the pump and the heart and lungs return to normal pumping and oxygenation tasks. Some operations can be performed without using a heart-lung pump, and these operations are called “closed heart surgery ameliyat. Some open heart surgery may require surgery with a technique called hypothermia.
Hypothermia: In this technique, the child's body temperature is lowered, blood flow is slowed down and even stopped and the heart is safely repaired.
Intensive Care Period: After the operation, the child is taken to the intensive care unit. Specially trained doctors, nurses and technicians are available 24 hours a day. Your child is monitored with computerized electronic devices for all vital functions in intensive care. Do not worry about the devices in intensive care and the tubes attached to the child. These are all necessary and routinely used equipment. When this is no longer needed, all of this equipment is slowly withdrawn from your child.
Long-term follow-up and control: Regular check-ups are very important in the treatment of the child. After the diagnosis of congenital heart disease and heart surgery, control appointments are given in days, weeks and months, and then the frequency of these appointments decreases gradually. Depending on the child's problem, regular examinations and examinations may be necessary. These reviews:
• blood tests
• electrocardiography (ECG)
• 24-hour ECG follow-up holter examination
• chest film
• exercise test
• Some children require angiography (cardiac catheterization).
• dental interventions that may cause bleeding in the gums or mouth
• some gastrointestinal, reproductive and urinary tract surgeries and interventions
Physical Activity and Sports
Most children with congenital heart disease can live a physically fully active life. Stating that there is no need to put any restrictions on the daily activities of these children. Dr. Prof. Dr. Tayyar Sarıoğlu and Prof. Dr. Ayşe Sarıoğlu, they give the following information:
However, parents may impose unnecessary restrictions on their child's physical activities. This will prevent your peer from meeting with your child and cause a decrease in your child's physical condition and quality of life. For these reasons, pediatric cardiologists encourage your child to live a physically active life. This increases your child's heart and lung condition and leads to a better quality of life. “
Mother with Congenital Heart Disease
Most of the patients who have a mild defect in the heart and undergo successful surgery can have normal birth after a natural pregnancy period. In some congenital heart diseases (severe heart disease or bruising), pregnancy can be dangerous to health and birth control methods should be used. Professor Dr. Prof. Dr. Tayyar Sarıoğlu and Prof. Dr. Ayşe Sarıoğlu recommends the following to mothers with congenital heart disease: her Each patient should be evaluated separately on how to achieve birth control. Some patients prefer to use other methods instead of birth control pills. Your cardiologist can advise you on which contraceptive method to choose. In general, the probability of giving birth to children with congenital heart disease in the community is approximately 1 in 100 births. This rate is slightly higher in siblings and siblings (girls or boys) if there is congenital heart disease and if the mother or father has congenital heart disease. In half of the children born with heart problems, the problem is similar to the mother's heart disease. Congenital heart diseases can be diagnosed by echocardiography when the baby is in the womb. Pregnant women should feed well during pregnancy and should not smoke or drink alcohol. During this period, he should only use medications approved by his doctor. “