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What are the findings from the 2D and colour doppler study of my child?

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Practicing since : 1998
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Hi, i have a 14 days old baby girl.When she was days old her 2D and colour doppler study was carried out .The findings are as follows: - Siitus solitus - Pulmonary veins drain normally in LA -Vena cavae drain normally in RA -Atrioventricular and Ventriculoarterial concordance -Great vessels are normally related -Aortic arch is left sided -Dilated RA and RV -Common AV valve defect -Mild common AV valve regurgitation -Large inlet VSD measuring 7.5mm with bi-directional shunting -Small ostium primum ASD measuring 3mm with bi-directional shunting -Additional small ostium secundum ASD measuring 5mm with bi-directional shunting -Moderate sized patent ductus arteriosus with bi-directional shunting -Severe pulmonary hypertension -Good biventricular function -No coarctation of the aorta -No effusion, clots or vegetations Questions: - Was the 2D study done to early on a 4 days old baby -How serious is the case and is there a possibility of holes closing on own or would it need a medical intervention and if so by when. -The probability of success in case of medical intervention.Can this happen in one sitting or would need multiple intervention -Would medical intervention ensure 100% normal life. My baby weight at birth was 2.3 kgs and after 14 days she is measuring 2.45 kgs
Posted Wed, 20 Nov 2013 in Congenital Heart Disease
Answered by Dr. Sukhvinder Singh 23 hours later
Brief Answer: please see below Detailed Answer: Dear Sir 1. TIMING OF ECHO- No. There is nothing too early. It depends upon the symptoms and signs of heart disease & on the judgement of clinician. In fact we do look for for these anomalies even when the child has not born (Fetal ECHO). 2. Complete AV canal defects do not close on their own. They require surgical correction. The timing of Correction will be best judged by a paediatric cardiologist as it requires assessment of clinical status also. 3. The success rate varies in various case series. Recently, some centers have reported success rates of nearly 95% in infancy. However it depends upon the age of patient at time of operation, degree of common AV valve regurgitation, presence of heart failure/ symptoms, expertise of center etc. 4. NUMBER OF PROCEDURES- It depends upon the clinical circumstances. Sometime a procedure called pulmonary banding will be done before undertaking complete repair. Sometime they will go for complete repair in first instance. Definitely some patients may require repeat surgery, especially for the valve related issues. 5. I am afraid, nothing is 100% in medicine as 100% is not in human hands. Still the best person to answer this will be your cardiac team (pediatric cardiologist and pediatric cardiac surgeon). I would recommend that you consult a paediatric cardiologist at earliest and proceed accordingly. Hope this helps. Sincerely Sukhvinder
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Follow-up: What are the findings from the 2D and colour doppler study of my child? 7 hours later
Hi, with reference to the details provided by me in my question i would like to understand : - If findings are serious and are they life threatening (my baby is currently 15 days old and our next follow up with peadatrician cardiologist has been suggested at 3 mths ).Reason does it warrant a immediate intervention - The 3 holes size : 3mm, 5 mm and 7.5 mm are they small size or medium or large size ...meaning in medical terminology how are these holes categorized - Are there any possibilities of the holes closing on its own (previous historical evidence) - Any ball path cost estimate for repairing the complete heart defect
Answered by Dr. Sukhvinder Singh 8 hours later
Brief Answer: please see below Detailed Answer: Dear Sir 1. If the paediatric cardiologist has already seen and asked for a follow-up , you must seem him at schedule. If child develops excessive unusual breathing rate (more than what she normally has) or there is difficulty in feeding her or there is not expected gain in weight, you should see him earlier. Or if paediatric cardiologist has not seen her as yet, please do see him at earliest. Seriousness is not judged by reports, it is judged by clinical examination and other parameters too. It is best assessed by the treating physician. 2. In AV canal defect we do not go by small medium or large size as these are variable in variable part of cardiac cycle and are a part of a common basic malformation. Moreover whatsoever be the size, surgical correction is to be done. Ostium secundum ASD is separate entity and is medium sized. 3. I already answered that complete AV canal defect will require surgical correction. Ostium secundum defect of size 5 mm may close spontaneously. 4. Sorry, Estimates will be provided by treating hospital only. Sincerely Sukhvinder
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