MD. FNB, Pediatric Cardiologist
Dr Ravi Ranjan Tripathi Is A Graduate From Mgm Medical College, Indore. He Completed His Post Graduation (md Pediatrics) From Gandhi Medical College, Bhopal. He Was Granted “fellowship In Neonatal Intensive Care” At B J Wadia Hospital For Children, Mumbai. Pursuing His Interest In “pediatric Cardiology” He Joined Fellowship In “kokilaben Dhirubhai Ambani Hospital And Research Centre” In Mumbai. He Was Selected For “fellowship National Board Fnb” In Pediatric Cardiology And Spent Two Years At “frontier Lifeline Hospital & Dr K M Cherian Heart Foundation” In Chennai Among The Pioneers In The Field Of Pediatric Cardiac Care. He Has Been Trained In Neonatal And Pediatric Echocardiography, Pediatric Cardiac Catheterization, Pediatric Transcatheter Interventions Like Device Closures, Balloon Angioplasties, Stent Angioplasties, Etc. Ravi Ranjan Tripathi Is “interventional Pediatric Cardiologist” At Indore Mp. He Specializes In Treatment Of Newborns, Children And Adults With “structural And Congenital Heart Defects”. Since 2012 He Has Performed More Than 500 Pediatric Cardiac Interventions Including Device Closures, Balloon Valvuloplasties, Stent Angiooplasties In Indore. He Is Visiting Faculty To Different Centres In MP And Central India
Congenital Heart Defects
Facts about CHD
- Congenital heart defects are problems with the heart’s structure that are present at birth.
- Congenital heart defects change the normal flow of blood through the heart.
- Congenital heart defects are the most common type of birth defect, affecting 8 out of every 1,000 newborns.
- There are many types of congenital heart defects ranging from simple to very complex.
- Doctors don’t know what causes most congenital heart defects. Heredity may play a role.
- Severe defects can cause symptoms such as:Rapid breathing, bluish tint to skin, lips, and fingernails. This is called cyanosis, Fatigue (tiredness), Poor blood circulation.
- Serious heart defects are usually diagnosed while a baby is still in the womb or soon after birth. Some defects aren’t diagnosed until later in childhood, or even in adulthood.
- An echocardiogram is an important test for both diagnosing a heart problem and following the problem over time. This test helps diagnose problems with how the heart is formed and how well it’s working. Other tests include EKG (electrocardiogram), chest x ray, pulse oximetry, and cardiac catheterization.
- Doctors treat congenital heart defects with catheter procedures and surgery.
- Treatment depends on the type and severity of the defect.
- With new advances in testing and treatment, most children with congenital heart defects grow into adulthood and can live healthy, productive lives. Some need special care all though their lives to maintain a good quality of life.
Types of Congenital Heart Defects
Holes in the Heart (Septal Defects) – ASD, VSD, PDA
The septum is the wall that separates the chambers on left and right sides of the heart. The wall prevents blood from mixing between the two sides of the heart. Some babies are born with holes in the septum. These holes allow blood to mix between the two sides of the heart.
An ASD is a hole in the part of the septum that separates the atria—the upper chambers of the heart. The hole allows oxygen-rich blood from the left atrium to flow into the right atrium, instead of flowing into the left ventricle as it should. Many children who have ASDs have few, if any, symptoms.ASDs can be small, medium, or large. Small ASDs allow only a little blood to leak from one atrium to the other. They don’t affect how the heart works and don’t need any special treatment. Many small ASDs close on their own as the heart grows during childhood.
Medium and large ASDs allow more blood to leak from one atrium to the other. They’re less likely to close on their own.About half of all ASDs close on their own over time. Medium and large ASDs that need treatment can be repaired using a catheter procedure or open-heart surgery.
A VSD is a hole in the part of the septum that separates the ventricles—the lower chambers of the heart. The hole allows oxygen-rich blood to flow from the left ventricle into the right ventricle, instead of flowing into the aorta and out to the body as it should.
VSDs can be small, medium, or large. Small VSDs don’t cause problems and may close on their own. Medium VSDs are less likely to close on their own and may require treatment.Large VSDs allow a lot of blood to flow from the left ventricle to the right ventricle. As a result, the left side of the heart must work harder than normal. Extra blood flow increases blood pressure in the right side of the heart and the lungs.The heart’s extra workload can cause heart failure and poor growth. If the hole isn’t closed, high blood pressure can scar the arteries in the lungs.Doctors use open-heart surgery to repair VSDs. Now Transcatheter device closure can close some types of VSDs.
Patent ductus arteriosus (PDA) is a fairly common heart defect that can occur soon after birth. In PDA, abnormal blood flow occurs between the aorta and the pulmonary artery.Before birth, these arteries are connected by a blood vessel called the ductus arteriosus. This blood vessel is an essential part of fetal blood circulation. Within minutes or up to a few days after birth, the ductus arteriosus closes.In some babies, however, the ductus arteriosus remains open (patent). The opening allows oxygen-rich blood from the aorta to mix with oxygen-poor blood from the pulmonary artery. This can strain the heart and increase blood pressure in the lung arteries.A heart murmur might be the only sign of PDA. (A heart murmur is an extra or unusual sound heard during a heartbeat.) Other signs and symptoms can include shortness of breath, poor feeding and growth, tiring easily, and sweating with exertion.PDA is treated with medicines, catheter-based procedures, and surgery. Small PDAs often close without treatment.
Valvular Stenosis (AS / PS)
Simple congenital heart defects also can involve the heart’s valves. These valves control the flow of blood from the atria to the ventricles and from the ventricles into the two large arteries connected to the heart (the aorta and the pulmonary artery).
Valves can have the following types of defects:
This defect occurs if the flaps of a valve thicken, stiffen, or fuse together. As a result, the valve cannot fully open. Thus, the heart has to work harder to pump blood through the valve.
This defect occurs if a valve doesn’t form correctly and lacks a hole for blood to pass through. Atresia of a valve generally results in more complex congenital heart disease.
This defect occurs if a valve doesn’t close tightly. As a result, blood leaks back through the valve.
The most common valve defect is pulmonary valve stenosis, which is a narrowing of the pulmonary valve. This valve allows blood to flow from the right ventricle into the pulmonary artery. The blood then travels to the lungs to pick up oxygen.Pulmonary valve stenosis can range from mild to severe. Most children who have this defect have no signs or symptoms other than a heart murmur. Treatment isn’t needed if the stenosis is mild.
In babies who have severe pulmonary valve stenosis, the right ventricle can get very overworked trying to pump blood to the pulmonary artery. These infants may have signs and symptoms such as rapid or heavy breathing, fatigue (tiredness), and poor feeding. Older children who have severe pulmonary valve stenosis may have symptoms such as fatigue while exercising.Some babies may have pulmonary valve stenosis and PDA or ASDs. If this happens, oxygen-poor blood can flow from the right side of the heart to the left side. This can cause cyanosis. Cyanosis is a bluish tint to the skin, lips, and fingernails. It occurs because the oxygen level in the blood leaving the heart is below normal.Severe pulmonary valve stenosis is treated with a catheter procedure.
- Cardiac Catheterization
- Pulse Oximetry
- ECG (Electrocardiogram)
- Chest X-Ray
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Catheter procedures are much easier on patients than surgery. They involve only a needle puncture in the skin where the catheter (thin, flexible tube) is inserted into a vein or an artery.
Doctors don't have to surgically open the chest or operate directly on the heart to repair the defect(s). This means that recovery may be easier and quicker.The use of catheter procedures has increased a lot in the past 20 years. They have become the preferred way to repair many simple heart defects, such as atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA) and pulmonary and aortic valve stenosis.For A DEVICE CLOSURE repair, the doctor inserts a catheter into a vein in the groin (upper thigh). He or she threads the tube to the heart's septum. A device made up of two small disks or an umbrella-like device is attached to the catheter.When the catheter reaches the septum, the device is pushed out of the catheter. The device is placed so that it plugs the hole between the atria. It's secured in place and the catheter is withdrawn from the body.Within 6 months, normal tissue grows in and over the device. The closure device does not need to be replaced as the child grows.
For valve stenosis, the doctor inserts a catheter into a vein and threads it to the heart's pulmonary valve. A tiny balloon at the end of the catheter is quickly inflated to push apart the leaflets, or "doors," of the valve.Then, the balloon is deflated and the catheter and ballon are withdrawn. This procedure can be used to repair any narrowed valve in the heart.To help guide the catheter, doctors often use echocardiography (echo), transesophageal echo (TEE), and angiography.