Children Heart Surgery in Bangkok
Every child is precious and the joy they bring to their parents and family is boundless. Every young mind and personality develops in its own way, and with limitless energy, it’s a pleasure to watch our children grow. Fortunately, the vast majority of youngsters are allowed to enjoy their young formative years with healthy, carefree abandon. Sadly, there are a few children that face challenges that restrict them throughout their wonder years. Every year there are children that are diagnosed with heart defects or disease. This robs them of much of, what might be seen as, a conventional childhood. For some, it can mean a childhood dominated by hospitals, doctors, and debilitation.
Heart defects in children can take many forms and can involve heart surgery as part of a young patient’s treatment. Surgery on such a delicate organ which is still developing in a young body requires extreme knowledge and skill by the very best surgical doctors.
Fortunately, in Bangkok there are dedicated specialists that work tirelessly to improve the lives of children with heart problems. The capital’s leading pediatric cardiac surgeons have improved the lives of countless children, both indigenous and from overseas, through their skill and dedication allowing these precious youngsters to enjoy their wonder years.
What is a Pediatric Heart Surgeon?
A pediatric cardiac surgeon is of course a heart surgeon, but one who has undergone specialized training in treating children with heart conditions. Their skills and knowledge is all encompassing, from diagnostics and surgery to treatment of complex conditions and disease management, for newborn babies, children and adolescents alike.
Pediatric cardiac surgeons are very highly trained doctors. Typically, following 4 years of medical school they will have completed 5 years of general surgical residency and 2 to 3 years of cardiothoracic residency. This would be followed by further specialist training in pediatric cardiac surgery of between 2 and 4 years.
Bangkok now has some of the most renown pediatric cardiac surgeons working in the best hospitals to be found in South East Asia. Supatra Chareekaew, M.D. Wannisa Poocharoen, M.D. Orapich Kayankid, M.D. to name but three. Many of the leading hospitals have dedicated newborn and pediatric surgery centers where these top physicians are saving lives and improving the life quality for many children.
Typical Pediatric Cardiac Conditions
Congenital heart defects, or CHDs, are the most common form of birth defects. There are many forms of CHDs, all of which present their own problems. They all have varying degrees of severity, size and location within the heart. In severe cases, blood vessels or heart chambers may be missing, performing poorly or inappropriately located. Critical congenital heart defects affect around 1% of all babies born with a CHD.
Some of the typical defects that surgical teams face are:
Ventricular Septal Defect (VSD)
Atrial Septal Defect (ASD)
Atrioventricular Septal Defect (AVSD)
Aortic Stenosis
Pulmonary Stenosis
Transposition of the Great Arteries
Tricuspid Atresia
Truncus Arteriosus
Tetralogy of Fallot (TOF)
Hypoplastic Left Heart Syndrome (HLHS)
All of these heart defects are routinely and successfully operated on by Bangkok’s pediatric cardiac surgeons whose talents and skills are renowned.
Typical signs of these disorders are hypoxia, this is where there is insufficient oxygen in the blood. This is often seen with blue or grey skin, lips or nail beds, known as cyanosis. Arrhythmias, this is when there are problems with the heart’s rate and rhythm, is another common indicator, as is a lack of growth and development in a young child
How is Pediatric Cardiac Surgery Performed
All cardiac surgical procedures are delicate operations, and even more so in the very young. There are 3 surgical techniques commonly used by surgeons. A term which is familiar to most people is, ‘open heart surgery’, this is when the surgical team uses a heart-lung bypass machine.
The surgeon will make an incision through the sternum, or breastbone with the patient under a general anesthetic, meaning the child is asleep throughout the surgical procedure and feels no pain or discomfort.
The heart-lung bypass machine re-routes the blood through a series of tubes, oxygenates it and keeps it at the optimum temperature whilst continuing to circulate it around the rest of the body. This then allows the surgeon to carry out delicate procedures on the heart.
Effectively, at this point the heart is no longer working. With the heart in an inert state the surgeon is able to repair the muscle, the heart valves and the blood vessels that service the organ. On completion of the surgical repair the heart can be restarted and the machine disconnected from the patient. The sternum and the outer incision can then be closed.
There are some heart surgery procedures where access is gained via the side of the chest, between the ribs. Sometimes known as ‘closed-heart surgery’, the medical term is thoracotomy. It is common for this surgical procedure to be carried out using specialist equipment and with the surgeon working by way of optical imagery provided by a small camera.
The third method of accessing the heart for a surgical procedure is via an artery in the leg. Although being the least invasive method of heart surgery, it is limited in its use purely due to the type of procedures that can be undertaken via arterial access to the heart. Minimally invasive surgery, or MIS, has many benefits, particularly for the very young as it reduces operative trauma.
The instruments used are very small, ranging from 2 to 5 millimeters in diameter which results in a smaller area of tissue being affected by surgical procedures. By utilizing MIS there is also a reduction in the risk factor that accompanies any surgical procedure, smaller incisions lead to reduced blood loss.
With MIS scarring is also greatly reduced. In cases of pediatric MIS incisions will only be 2 to 5 millimeters long and can normally be closed with no more than 2 stitches. Traditional surgical techniques may take up to eight weeks for the patient to recover, with MIS this is vastly reduced, to as little as two weeks.
The traditional techniques used in cardiac surgery normally require an extended stay in the hospital, whereas with MIS, very often, a patient can be discharged after 24 hours. This is a win-win situation for all concerned, including the hospital. A reduced stay in hospital reduces inconvenience and stress for the patient and for their family. Bangkok has certainly become a leader in pediatric cardiac surgery through its leading surgical talent, modern hospitals, dedicated units, and a committed belief in the health and wellbeing of children, not just indigenous, but from all over the world.
