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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Probability Of Open Heart Surgery In Infants

A hole in heart is found in my 2 months old daughter. I have the doppler report with me. it is showing parameters "LA: 20mm Velocity", "AORTA: 15mm Cradient", "PA 59% E.T", "EFSS 26% E/Vel"Color Flow Mapping: "VSD= 39mmHG" "TR=30mmHG"Detail Report:1. Levocardia with situs solitus 2. Normal Pulmonary and systemic venous connections 3. Atrioventricular and ventriculoarterial concordance 4. Intact IAS5. Moderate to large size perimembraneous outlet restricted VSD (5.3mm)6. Detailed LV with good systolic function7. Mild TR8. No PDA9. No Coarctation of aorta10. Left aortic arch11. No Pericardial effusion Diagonsis and comments Moderate to large size perimembraneous outlet restricted VSD (5.3mm)Left Ventricular volume overloaded Mild pulmonary hypertension Doctor has suggested me medicines Tab spinomide 20 (1/5+1/5 daily), Tab Capine 12 (1/6+1/6+1/6 daily), Tab Digaxin (1/12 daily not on Sundays) for 2 monthsMy daughter was 1/2 kg under weight when born, and now she is 3.5 kgs while she must be at least 4 kgs. My concerns are; what is the probability of open heart surgery as the hole is moderate to large now?how much time will it take normally for heart to cover the hole naturally in the cases like my daughter?what are the chances of getting normal life with out having life threat?What will be the effects on growth?In case of surgery (God Forbid), can she be able to get normal life (running, walking etc)?
Mon, 5 Jan 2015
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General & Family Physician,  's  Response
Hi, your child has a moderate to large sized Perimembranous VSD with Pulmonary hypertension with PA pressure 59%. Perimembranous VSD close by 6 months of age in 35% of cases. Surgical closure of VSD will be required if the child has failure of growth not responding to Medications, If the PA is >50%, or if the child has CHF not responding to medical therapy.
Since your child has a PA >50% and has large VSD with pulmonary hypertension, he might be a candidate for surgical closure of the defect. The operation is not an Open heart surgery. It done Via a cardiac bypass. Mortality post operative is very less and child recovers well. Once the defect closes, CHF improves and the child will recover his growth well. Yes, he will be able to lead a normal life and do all the activities. Surgery is usually performed around 6 months of age when the child has adequate weight gain.( can be done by 3 to 4 months also)
Thanks and regards.
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Suggest Probability Of Open Heart Surgery In Infants

Hi, your child has a moderate to large sized Perimembranous VSD with Pulmonary hypertension with PA pressure 59%. Perimembranous VSD close by 6 months of age in 35% of cases. Surgical closure of VSD will be required if the child has failure of growth not responding to Medications, If the PA is 50%, or if the child has CHF not responding to medical therapy. Since your child has a PA 50% and has large VSD with pulmonary hypertension, he might be a candidate for surgical closure of the defect. The operation is not an Open heart surgery. It done Via a cardiac bypass. Mortality post operative is very less and child recovers well. Once the defect closes, CHF improves and the child will recover his growth well. Yes, he will be able to lead a normal life and do all the activities. Surgery is usually performed around 6 months of age when the child has adequate weight gain.( can be done by 3 to 4 months also) Thanks and regards.