An 11-day-old patient with aortopulmonary window disease - a very rare congenital heart disease that causes heart failure and has a high risk of death - has just been successfully saved by surgery by doctors at E Hospital.
It is worth mentioning that in the past, when performing surgery for this disease, the sternum had to be sawed, but the doctors at E Hospital, with experience in performing more than a thousand minimally invasive surgeries on children, decided to choose the minimally invasive aorto-pulmonary window closure surgery method for children, helping children avoid having to saw the sternum.
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| Dr. Do Anh Tien, Head of Pediatric Cardiovascular Surgery Department, is examining a child patient. |
The patient was admitted to the hospital with increasing difficulty breathing, rapid breathing, refusal to breastfeed, and severe heart failure. Previously, the patient had been diagnosed with a rare congenital heart disease while still in the womb through ultrasound screening. However, the family decided to keep the pregnancy because the patient’s twin had another baby…
As soon as the patient was admitted, doctors from the Pediatric Cardiovascular Surgery Department, Cardiovascular Center, E Hospital quickly consulted and developed a treatment plan to ensure the child's safety.
Doctors chose a minimally invasive surgical approach to close the window to avoid the patient having to undergo a major open surgery and sternum sawing.
Dr. Do Anh Tien, Head of the Department of Pediatric Cardiovascular Surgery, Cardiovascular Center, E Hospital, said that the aortopulmonary window is a rare congenital heart defect (accounting for 0.5% of congenital heart diseases), a condition in which there is a communication between the ascending aorta and the pulmonary artery right above the sigmoid valve. This is a rare congenital heart disease, caused by an abnormality in the common wall of the artery into the aorta and pulmonary artery.
Dr. Do Anh Tien explained that the aortopulmonary window is divided into 3 types (depending on the location of the window): Type 1, the aortopulmonary window is located between the ascending aorta and the pulmonary artery right above the sinus of valsalva; Type 2, the window is located further away, between the ascending aorta and the origin of the right pulmonary artery from the pulmonary trunk; Type 3, the right pulmonary artery originates from the aorta.
If the window size is small, the patient can be treated with medication, then wait until the conditions are right before surgery.
In cases where the patient does not respond to medication, has severe heart failure, or severe pulmonary hypertension, doctors must choose early surgery to save the child's life first.
In this patient's case, Dr. Do Anh Tien shared that this is a special case, the patient was discovered while still in the womb, a twin pregnancy, so when born the baby only weighed 2.3kg, a difficult problem for doctors because with low weight there will be many risks when performing surgery with extracorporeal circulation (the baby has a weight of
Therefore, the first option doctors think of is to use medication for treatment, waiting until the patient is eligible in all aspects before performing surgery on the patient.
However, when the child's physical condition did not respond to medication, the heart failure became more severe, with a high risk of death, forcing doctors from the Pediatric Cardiovascular Surgery Department, Cardiovascular Center, E Hospital to immediately plan surgery for the child.
To perform surgeries like this, doctors must choose the classic surgical option - sawing the patient's sternum, causing pain with a high level of invasiveness and a high risk of complications.
Furthermore, performing a heart surgery on a child is very difficult, requiring work from diagnosis, treatment indications, anesthesia and resuscitation... This depends largely on the expertise of surgeons with many years of experience in complex congenital heart surgery.
With more than 10 years of experience in minimally invasive surgery for children with congenital heart disease, after consulting and calculating all possible outcomes for the patient, the doctors of the Pediatric Cardiovascular Surgery Department decided to choose the minimally invasive surgery option through the right axillary approach to patch the aortopulmonary window for this patient, helping the child avoid having to saw the sternum, recover quickly after surgery and be aesthetically pleasing.
Sharing about the difficulties in performing this surgery, Dr. Tien said that the biggest difficulty was that the baby was only a few days old, had a very low weight, and had a type 2 window, so minimally invasive surgery would be much more difficult because the surgical field was small and the window was close to the aortic arch. However, with consultation and our experience, we were able to successfully perform this technique.
According to Dr. Tien, in the past, when children got this disease, the disease progressed very severely and often resulted in death before the age of 15. If surgery was not performed early, about 40% of children died in the first year. Some dangerous complications of the disease include: heart failure, pulmonary hypertension, pneumonia, Eisenmenger syndrome, etc.
But now, along with the development and current trends in the world, the Cardiovascular Center, E Hospital has deployed many new techniques, in which minimally invasive techniques are prioritized and focused on, especially in congenital heart surgery.
Because children's bodies are still small, minimally invasive techniques will be very beneficial for the treatment process and future growth, bringing high efficiency such as: patients do not have to suffer pain after surgery, recover well after surgery; no sternum deformity after surgery; especially for girls, aesthetic problems are no longer a concern.
Currently, the Cardiovascular Center, E Hospital is a complete cardiovascular facility including surgery, internal medicine and cardiovascular intervention, anesthesia and resuscitation... with modern, synchronous equipment ensuring examination and treatment of heart, blood vessel and chest diseases for patients.
Dr. Do Anh Tien warns that aortopulmonary window is a rare congenital heart disease that causes severe complications and a high risk of death, so early diagnosis and treatment are very important. Fortunately, this is a disease that can be detected through prenatal screening.
Therefore, mothers need to have a full check-up during pregnancy to screen for all possible risks to the fetus. In case of unfortunate heart abnormalities detected in the baby, doctors will have a plan to monitor the pregnancy and provide the earliest treatment plan, helping to bring a healthy heart to the baby.
Source: https://baodautu.vn/cuu-song-benh-nhi-11-ngay-tuoi-mac-benh-tim-bam-sinh-d225643.html
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