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Angioplasty

Angioplasty (or Balloon angioplasty) is an endovascular procedure to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis. An empty, collapsed balloon, known as a balloon catheter, is passed over a wire into the narrowed locations and then inflated to a fixed size. The balloon forces expansion of the stenosis (narrowing) within the vessel and the surrounding muscular wall, opening up the blood vessel for improved flow, and the balloon is then deflated and withdrawn. A stent may or may not be inserted at the time of ballooning to ensure the vessel remains open.

Reasons

  • Greatly increases blood flow through the blocked artery.
  • Decreases chest pain (angina).
  • Increases ability for physical activity.
  • Reduces risk of a heart attack.
  • Can also be used to open neck and brain arteries to help prevent stroke.

Open Heart / Beating Heart Surgery

Open heart surgery:

    Open heart surgery is any type of surgery where the chest is cut open and surgery is performed on the muscles, valves, or arteries of the heart.

    This is the most common type of heart surgery done on adults. During this surgery, a healthy artery or vein is grafted attached to a blocked coronary heart artery. This allows the grafted artery to “bypass” the blocked artery and bring fresh blood to the heart.

Beating Heart Surgery:

    Beating-heart surgery is a way to perform surgery without stopping the heart. Surgeons use a special device to stabilize the part of the heart on which they are operating. The heart continues to beat and circulate blood to heart muscle during the operation. Surgery on a beating-heart helps reduce the risk for complications associated with temporarily stopping the heart during surgery.

Advantages of beating-heart surgery:

  • Better preservation of heart function
  • Better survival rate, especially among high-risk patients
  • Reduced hospital stay
  • Quicker recovery
  • Less chance for heart rhythm, kidney, or liver complications
  • Reduced risk for neurological injury, including stroke and memory complications

Atrial Septal Defect (ASD)

A "hole" in the wall that separates the top two chambers of the heart. This defect allows oxygen-rich blood to leak into the oxygen-poor blood chambers in the heart. ASD is a defect in the septum between the heart's two upper chambers (atria). The septum is a wall that separates the heart's left and right sides.

Heart has two sides, separated by an inner wall called the septum. With each heartbeat, the right side of your heart receives oxygen-poor blood from your body and pumps it to your lungs. The left side of your heart receives oxygen-rich blood from your lungs and pumps it to your body.

The septum prevents mixing of blood between the two sides of the heart. However, some babies are born with holes in the upper or lower septum.

A hole in the septum between the heart's two upper chambers is called an atrial septal defect (ASD). A hole in the septum between the heart's two lower chambers is called a ventricular septal defect (VSD).

ASDs and VSDs allow blood to pass from the left side of the heart to the right side. This means that oxygen-rich blood can mix with oxygen-poor blood. As a result, some oxygen-rich blood is pumped to the lungs instead of out to the body.

Over the past few decades, the diagnosis and treatment of ASDs and VSDs have greatly improved. Children who have simple congenital heart defects can survive to adulthood and live normal, active, and productive lives because their heart defects close on their own or have been repaired.

Atrial Septal Defect Complications

  • Right heart failure:
    An ASD causes the right side of the heart to work harder because it has to pump extra blood to the lungs. Over time, the heart may become tired from this extra work and not pump well.
  • Arrhythmias (ah-RITH-me-ahs):
    Extra blood flowing into the right atrium through an ASD can cause the atrium to stretch and enlarge. Over time, this can lead to arrhythmias (irregular heartbeats). Arrhythmia symptoms may include palpitations or a rapid heartbeat.
  • Stroke:
    Usually, the lungs filter out small blood clots that can form on the right side of the heart. Sometimes a blood clot can pass from the right atrium to the left atrium through an ASD and be pumped out to the body. This type of clot can travel to an artery in the brain, block blood flow, and cause a stroke.
  • Pulmonary hypertension (PH):
    PH is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen. Over time, PH can damage the arteries and small blood vessels in the lungs. They become thick and stiff, making it harder for blood to flow through them.
Signs and Symptoms:
    Many babies who are born with atrial septal defects (ASDs) have no signs or symptoms. When signs and symptoms do occur, heart murmur is the most common. A heart murmur is an extra or unusual sound heard during a heartbeat.
    Often, a heart murmur is the only sign of an ASD. However, not all murmurs are signs of congenital heart defects. Many healthy children have heart murmurs. Doctors can listen to heart murmurs and tell whether they're harmless or signs of heart problems.
    Over time, if a large ASD isn't repaired, the extra blood flow to the right side of the heart can damage the heart and lungs and cause heart failure. This doesn't occur until adulthood. Signs and symptoms of heart failure include:
  • Fatigue (tiredness)
  • Tiring easily during physical activity
  • Shortness of breath
  • A buildup of blood and fluid in the lungs
  • A buildup of fluid in the feet, ankles, and legs

Ventricular Septal Defect (VSD)

VSD is a hole in the wall separating the two lower chambers of the heart.

In normal development, the wall between the chambers closes before the fetus is born, so that by birth, oxygen-rich blood is kept from mixing with the oxygen-poor blood. When the hole does not close, it may cause higher pressure in the heart or reduced oxygen to the body.

What causes it?

In most children, the cause isn't known. It's a very common type of heart defect. Some children can have other heart defects along with VSD.

How does it affect the heart?

Normally, the left side of the heart only pumps blood to the body, and the heart's right side only pumps blood to the lungs. In a child with VSD, blood can travel across the hole from the left pumping chamber (left ventricle) to the right pumping chamber (right ventricle) and out into the lung arteries. If the VSD is large, the extra blood being pumped into the lung arteries makes the heart and lungs work harder and the lungs can become congested.

Symptoms:

Signs and symptoms of serious heart defects often appear during the first few days, weeks or months of a child's life.

Ventricular septal defect symptoms in a baby may include:

  • Tires easily when eating or playing.
  • Is not gaining weight.
  • Becomes breathless when eating or crying.
  • Breathes rapidly or is short of breath.
  • Shortness of breath when you exert yourself or when you lie down.
  • Rapid or irregular heartbeat.
  • Fatigue or weakness.

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