Doctors at the Cardiovascular Center (Vinmec Times City International General Hospital) have just successfully performed a complete endoscopic surgery on a 3-year-old patient (in Nha Trang) with congenital heart disease. The success has made Vinmec one of the few cardiovascular centers in the world that can perform this advanced technique on young children, contributing to the advancement of Vietnamese medicine compared to the world.
Dr. Dang Quang Huy - Deputy Director of Cardiovascular Center, Vinmec Times City International General Hospital.
Dr. Dang Quang Huy - Deputy Director of the Cardiovascular Center - Vinmec Times City International General Hospital shared about the implementation of this difficult technique to bring many benefits to patients, especially pediatric patients.
- The technique of complete endoscopic surgery for children with congenital heart disease brings great benefits to patients, but why don't many cardiovascular centers in the world apply this technique, doctor?
Currently, not many countries and centers in the world apply the technique of full endoscopic surgery for children with congenital heart disease, because this is a difficult technique, requiring meticulousness and high care. Most developed countries such as the US and European countries focus on robotic endoscopic surgery for many adult cases - because this is a method with a highly effective technique.
As for pediatric patients, robotic endoscopic surgery is more difficult to perform because each robotic arm is bulky and very large, while the patient's body is small, the blood vessels are small, so the robotic arms can hardly reach to perform surgery, requiring the dexterity and meticulousness of surgeons with flexible hands and very high precision.
In the world, only China and Vietnam have mastered the technique of total endoscopic surgery for children with congenital heart disease and are applying it to pediatric patients. In the world medical literature, there are only 3-4 reports on research on total endoscopic surgery for heart disease applied to children.
- Can the doctor tell us what the consequences could be if the 3-year-old girl above does not receive timely surgery?
Dr. Quang Huy and doctors from many specialties coordinated a complete endoscopic surgery for a 3-year-old patient with congenital heart disease.
The baby's condition was first accurately diagnosed with ultrasound and cardiac CT scan results at Vinmec Nha Trang International General Hospital.
The baby weighed 18kg and had a congenital heart defect combined with multiple lesions, including a large atrial septal defect and all the veins of the right lung were not draining in the right place (flowing to the right heart instead of the left heart).
These abnormalities cause the child's heart chamber to dilate and increase pulmonary artery pressure. If not operated on early, it will cause pulmonary fibrosis and right heart failure. Therefore, even though the child is only 3 years old, the heart chamber is already as large as an adult's heart chamber.
This is the “golden” time for the child to intervene to bring the highest efficiency. With just one successful endoscopic surgery, the child can return to normal activities like other children. If the surgery is performed later, the patient will have symptoms of heart failure and severe pulmonary hypertension, which will be difficult to recover from, the surgery will not be highly effective and the patient's quality of life will be reduced.
- Doctor, what are the challenges for the medical team in the surgery of the above child patient?
After an online consultation with experts at Vinmec Times City Hospital, the patient was assigned to undergo full endoscopic surgery. This method will bring the best treatment results for the patient instead of open surgery or minimally invasive heart surgery as most medical facilities are currently performing.
The child recovered quickly and was able to walk just three days after surgery.
The girl's case is quite complicated because she is still suffering from pneumonia - a consequence of congenital heart disease. If left untreated, she will often have pneumonia and antibiotic treatment will become increasingly difficult and take a long time to cure.
Therefore, the surgery was also a challenge for doctors when solving the problem of treating both the heart and lungs of the child patient at the same time. The 5-hour surgery was successful.
After three days, the patient was able to walk and one week after surgery, the patient was able to run and jump normally. With this completely endoscopic surgery method, the patient's congenital heart disease was resolved, the patient only needed surgery once and the doctors will schedule a follow-up examination and check-up every 3-6 months, then once a year.
- Can you analyze the advantages that the endoscopic method brings to pediatric patients?
In the era of advanced medicine, endoscopic heart surgery has been performed in some hospitals, however, complete endoscopic surgery in children is still a challenge for surgeons around the world for two reasons: First, the child's chest is very small, endoscopic operations will be very difficult, requiring surgeons to be proficient in endoscopic techniques.
Second, the femoral vessels in infants are very small, making it difficult to establish extracorporeal circulation to support cardiac surgery. This poses a risk of damaging the infant's femoral vessels.
Total laparoscopic heart surgery is a heart surgery method performed through small holes in the chest wall, the size of these holes is only the size of a ballpoint pen tip or a fingertip, instead of having to open the chest like other surgical methods. The surgical scar will be similar to laparoscopic appendectomy, but the technique of total laparoscopic heart surgery is much more complicated.
With a very small incision, the child can recover very quickly, the hospital stay is short, there is less pain, less risk of bleeding, and the chest deformity due to sternum sawing or having to open the chest is avoided. More specifically, the surgical scar is very small, highly aesthetic, very suitable for young women and girls.
To implement this complete endoscopic method in children, the role of the support team such as anesthesia, resuscitation, rehabilitation and post-operative care also requires experience, qualifications and high expertise.
In addition, the combination of strict infection control procedures and the most advanced specialized equipment in surgery ensures that the surgery is safe, minimizing risks and complications during and after surgery.
Vinmec Times City International General Hospital is one of the few medical facilities in Vietnam today that can meet all the necessary requirements for such a challenging and difficult surgery.
It is worth noting that at the Hospital, the cost of endoscopic heart surgery is not higher than open surgery and patients undergoing heart surgery at Vinmec Times City enjoy full health insurance benefits.
The success of the surgery has affirmed Vinmec's pioneering position in the field of cardiovascular surgery and endoscopic cardiac surgery in Vietnam, opening up new prospects in the treatment of young patients with congenital heart disease requiring early intervention.
- Doctor, what should parents do to detect heart disease in children early, in order to have timely intervention at an early stage?
The total endoscopic surgery method is indicated for both adults and children with atrial septal defect, ventricular septal defect, ventricular septal defect, left atrial septal membrane, abnormal pulmonary vein drainage, etc., which are the most common and frequent heart diseases. However, cases of complex congenital heart disease with many lesions require open surgery.
Congenital heart disease in children has some diseases with unclear symptoms such as atrial septal defect. Therefore, if parents see their children sweating while playing, breathing rapidly, having recurrent respiratory infections, taking a long time to heal... they need to go to medical facilities to screen for congenital heart disease through echocardiography, from which further treatment directions will be given.
Thank you very much doctor!
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