Overview
Traditional form of treatment for coronary artery stenosis was coronary artery bypass grafting. Bailout percutaneous interventions are newer methods which are less interventional and have reduced risks. Aster Hospitals is well-equipped with the latest technology to deal with complex cardiac problems. At Aster Hospitals, all the doctors are well-trained to handle complex procedures.
Transcatheter pulmonary valve implantation is one such critical intervention that is gaining attention in India. It is a procedure to treat heart defects a child has had since birth. Compared to traditional open heart surgery, it is a minimally invasive procedure that helps children recover and return to regular activities quicker. In transcatheter pulmonary valve implantation, the doctor uses a catheter to implant a valve into the child's heart. The catheter is usually inserted through the child's leg, and the doctor manipulates it to place it at its precise location.
Transcatheter device closure programs for atrial septal defects are well established. The atrial septum is a wall separating the heart's left and right upper chambers. If a defect is present in this wall, the blood flows in the wrong direction, leading to extra blood pumping to the lungs. This extra blood can damage the lung blood vessels if left untreated. The structure of the heart may also get deformed.
Atrial septal defect transcatheter repair requires a catheter and a small device to close the hole. A catheter is passed through a blood vessel in the groin. The cardiologist moves the catheter to the heart's septum, and a small device comes out of the tube to plug the hole. Vascular plugs are versatile devices that are used to close extracardiac vascular communications. However, these trials have a smaller success rate.
Stents are one of the most common devices used in children with congenital heart defects. Stenting is performed in the right ventricular outflow tract and ductus arteriosus. It is also conducted in people with aortic coarctation and stenosed pulmonary arteries. Bioresorbable stents are encouraged in neonates with reduced blood flow to the lungs. It is believed that the use of bioresorbable material enhances neointimal proliferation. Vertical vein stenting is a bailout procedure performed in neonates suffering from total anomalous pulmonary venous drainage.
Intravascular and intracardiac stenosis is very common in congenital heart disease. Implantation of stents is integral to interventional procedures for stenotic lesions in pediatrics. Stenting is also helpful in conditions like extensive vessel dissection after balloon dilatation. However, there are better methods than ballooning if stenosis occurs for a long segment. Although intravascular stents are not approved for congenital lesions, their use in vascular lesions is considered the standard of care by all centers and medical professionals.
The following are the different types of stents available:
Balloon-expandable stents
Balloon-expandable stents are placed on balloons, positioned across the site of obstruction, and implanted by inflating the balloon. The size of the balloon determines the diameter of the stent. Although they are widely used, a few unfavorable characteristics have been seen. These include rigidity, flaring of the edges, vessel injury, rupture of the balloon, and unsatisfactory performance.
Self-expandable stents
Self-expandable stents exhibit elasticity. They are constrained within a covering delivery sheath and delivered at the stenosis site. These stents can be passed through tortuous vessels and lesions.
Balloon valvuloplasty is a minimally invasive, non-surgical procedure performed in children with narrow heart valves. They make the valve function better without the child undergoing any major surgery. However, there are a few risks associated with valvuloplasty. These include risk of valve leakage, bleeding from the catheter site, abnormal heart rhythms, and infection.
Balloon atrial septostomy is a procedure that creates a hole in the child's heart. This procedure is done as a part of a temporary solution to conditions that affect blood flow to the lungs. The oxygen-poor blood mixes with oxygen-rich blood and circulates throughout the body.
Health Conditions Treated
Congenital heart diseases
Atrial septal defects
Aortic coarctation
Stenosed pulmonary arteries.
FAQs
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What should one expect after balloon valvuloplasty?
After a child has undergone balloon valvuloplasty, they should avoid high-contact sports for at least 5–7 days after the procedure. The patient needs to follow up with the cardiologist and undertake a few tests, like electrocardiogram, to evaluate their overall cardiac health.
How can one predict if atrial septostomy is successful or not?
Atrial septostomy is considered successful when the amount of oxygen in the arteries increases by at least 10% and the hole is at least 33% wider than previously. After the procedure, there is hardly any pressure difference between both heart chambers.
What are the advantages of transcatheter closure of septal defects over operative closure?
Transcatheter closure of septal defects has a lower risk of mortality, morbidity, shorter length of stay, and lower cost than operative closure.
Can one go through airport security after having a valve replacement?
Yes, one can get X-rays and go through airport security scans after a valve replacement. However, a healthcare provider must be consulted if one wants to undergo an MRI.
When should one contact a doctor after undergoing balloon valvuloplasty?
Along with the routine follow-ups, as advised by the healthcare provider, patients who have undergone balloon valvuloplasty should contact their doctors if they experience symptoms like chest pain, decreased urination, fever, chills, nausea or vomiting, swelling in legs or abdomen, and excessive weight gain. The doctor should be consulted on an urgent basis.
What risks are associated with transcatheter repair of atrial septal defects in children?
The possible risks associated with the procedure are abnormal rhythms in the heart, infection, excessive bleeding, puncturing the heart, tear in the vessel in which the catheter is placed, collection of blood in the groin, and reduction in blood flow to the heart.
What are the complications associated with transcatheter pulmonary valve replacement?
Risks involved are formation of blood clots, damage to blood vessels, fever, high blood pressure in the lungs, infection, arrhythmia, and unexpected bleeding.
How long does the valve last?
The valve typically lasts 5 years but in some cases, it may last 10–15 years.
Advanced Technology & Facilities
Aster Hospitals is well-equipped with the latest technology to deal with complex cardiac problems. At Aster Hospitals, all the doctors are well-trained to handle complex procedures. The various bailout percutaneous pediatric interventions available at Aster Hospitals are as follows:
It is a procedure in which a hole is created in the baby's heart to maintain blood flow through the heart. Aster Hospitals are one of the few hospitals that offer this service to patients. The goal is to improve the stability and outcomes of high-risk babies at birth.
Stents are tiny mesh wire tubes that open the vessel so blood can flow through them. Although not an approved management method, stenting is a standard method of keeping the vessels patent. At Aster Hospitals, we have specialists who have high success rates in performing this procedure.
Atrial septal defects may persist even after birth. These can be closed non-invasively using transcatheter devices.
At Aster Hospitals, we perform valve replacements in our state-of-the-art catheterization laboratories that house the most advanced technologies in a comfortable environment.
