After congenital heart disease is cured by surgery, will it affect the future?

Congenital heart disease can be cured.

Congenital heart disease is a cardiac vascular malformation caused by abnormal development of fetal cardiac blood vessels, and it is the most common heart disease in childhood. In recent 20 years, due to the development of advanced modern examination techniques (such as cardiac catheterization, angiocardiography, color Doppler echocardiography and radionuclide angiocardiography, etc.). ) and the development of hypothermia anesthesia, cardiopulmonary bypass and heart surgery, many common congenital heart diseases can be accurately diagnosed and cured, and some complex heart malformations can also be treated by surgery.

【 Etiology 】 ① Heredity is the main internal cause.

(2) Any factors that affect the development of cardiac embryos in the fetal period may cause cardiac malformations, such as rubella, influenza, mumps, coxsackie virus infection, diabetes, hypercalcemia, etc. And pregnant women are exposed to radiation; Pregnant mothers take anticancer drugs or methylphenidate and other drugs.

Classification of congenital heart disease: According to whether there are abnormal channels between the left and right sides of the heart or between great vessels (aorta and vein), or whether there are cyanosis, congenital heart disease can be divided into ① left-to-right shunt type (latent cyanosis type), such as atrial septal defect, ventricular septal defect and patent ductus arteriosus.

② Right-to-left shunt type (cyanosis type): such as tetralogy of Fallot and dislocation of great vessels.

③ No shunt type (no cyanosis type): such as pulmonary artery stenosis and coarctation of aorta.

Symptoms ① Children's growth and development may lag behind their peers and are prone to respiratory infections.

② The presence or absence of cyanosis depends on the nature of cardiac malformation. Such as atrial septal defect, ventricular septal defect and patent ductus arteriosus, there is usually no cyanosis in the early stage, but it may appear after strenuous activity or crying, and it may appear with age in the later stage. Right-to-left shunt congenital heart disease with severe cardiac malformation, such as cyanosis in children with tetralogy of Fallot after birth or weeks to months, and it will gradually worsen. ③ Cardiac auscultation: Systolic murmur can be heard at the left edge of sternum, and the murmur of ventricular septal defect is lower, louder and thicker than that of atrial septal defect, which is widely spread to the fourth bureau; The murmur of atrial septal defect (ASD) is mild and confined to the left 2 ~ 3 intercostal space. The noise of patent ductus arteriosus is located in a high position, and its voice is loud and rough, which spreads widely between the second ribs and presents a continuous noise similar to machine rotation, which can be heard in both systolic and diastolic periods. The location and size of the murmur in tetralogy of Fallot vary with deformity, and the murmur is mild in severe cases.

④ Children with tetralogy of Fallot often squat and rest during speech movement to relieve shortness of breath, sometimes they may have syncope (temporary brain hypoxia) and even life-threatening convulsions; In addition, the fingers and toes of children with tetralogy of Fallot are swollen like drums, which are called fingers (toes).

It can be used for cardiac photography, electrocardiogram and echocardiography. Echocardiography has the greatest diagnostic value, which can show the size, location and blood flow of atrial septal defect and ventricular septal defect. Generally, cardiac catheterization and angiocardiography should be done before operation to further confirm the diagnosis and make good preparations before operation.

[Complications] Atrial septal defect, ventricular septal defect and patent ductus arteriosus are often prone to pneumonia and heart failure. Tetralogy of Fallot can often be complicated with cerebral thrombosis and brain abscess. Except atrial septal defect, all the above congenital heart diseases are prone to bacterial endocarditis.

〕 Treatment 〕 ① Surgical treatment: The radical cure of congenital heart disease is surgical treatment, and surgery can be performed at the age of 4 ~ 5. If the symptoms are serious or bacterial endocarditis can't be controlled for a long time, surgery should be performed in advance.

② Drug therapy: The drug therapy before the operation of congenital heart disease is mainly to avoid strenuous activity and prevent or treat infection. If there is heart failure, it should be actively treated.

Manifestations of congenital heart disease in children

Congenital heart disease is the most common cardiovascular disease in children, which can be diagnosed before the age of 3. Congenital heart disease is mainly caused by the stagnation or abnormality of fetal cardiovascular system in the early stage of fetal development, usually in the first three months of embryo. The more recognized reason is that pregnant women suffer from rubella, influenza and other viral infections; Pregnant women take hormones or other drugs that damage the fetus; The abdomen or pelvic cavity of pregnant women is irradiated by X-rays, ultrasonic waves, radionuclides, etc. Or severe nutritional deficiency and hypoxia in pregnant women. In addition to congenital heart disease, some children are accompanied by multiple deformities in the whole body, which often suggests that children with congenital heart disease are due to genetic defects in germ cells. Mild congenital heart disease can have no special symptoms, and its growth and development are normal. Only a rough loud noise was found in the left chest during physical examination. Children with severe congenital heart disease have obvious symptoms as early as newborn or infancy.

The symptoms of congenital heart disease are mainly in two aspects: (1) Cyanosis is found in the nasal tip, lips, nails and conjunctiva of children. At the same time of cyanosis, the child's growth and development are slow and his intelligence is low. When he is nursing or crying, he may have difficulty breathing. In severe cases, he may lose consciousness and twitch. Children who can walk often squat down automatically because of the feeling of lack of oxygen in their brains. (2) The symptoms of heart failure are dyspnea, shortness of breath, inability to lie flat, cough, tachycardia, blisters on both lungs, hepatomegaly, pallor and edema of lower limbs. Once the above symptoms are found, they must be sent to the hospital for emergency treatment immediately.

Treatment of congenital heart disease in children

Xinhua Wuxi Channel September 2 news: Congenital heart disease is a cruel "killer" that endangers the health and life of children, especially infants. According to statistics, about 6 out of every 1000 newborns suffer from congenital heart disease. According to the birth rate and the incidence of congenital heart disease, it is estimated that10.5 million sick children are born every year in China. Ventricular septal defect (VSD), atrial septal defect (VSD), patent ductus arteriosus (PDA) and pulmonary valve stenosis are the most common congenital heart malformations in clinic. Due to the lack of effective methods to prevent congenital heart disease and untreated congenital heart disease, half of them died at the age of one and two thirds died at the age of two. Therefore, early detection, early diagnosis and early treatment are the keys to reduce the natural mortality of the disease.

Because many congenital heart diseases have no specific clinical symptoms in the early stage, it is sometimes difficult to find them early. However, several common congenital heart malformations, if not corrected for a long time, will cause pulmonary hypertension and eventually lead to heart failure. Surgery is a traditional method to treat congenital heart disease, which has rich experience and therapeutic effect and is still developing. However, the trauma of congenital heart disease surgery is great, and sometimes there will be serious complications or unsatisfactory surgical treatment results, which has always been a difficult problem for doctors and parents. At present, there are two main methods to treat congenital heart disease in children: thoracotomy and interventional therapy. Thoracotomy is a traditional method, which is still used for complex congenital heart disease. However, due to the excessive surgical trauma, with the development of medicine, non-surgical interventional therapy is more and more widely used in the treatment of congenital heart disease in children.

1967, foreign experts such as P o r s t m a n took the lead in successfully blocking patent ductus arteriosus with interventional catheter, and then applied this method to the radical treatment of congenital atrial septal defect and pulmonary valve stenosis, especially with the development of medicine and related disciplines in recent years, congenital ventricular septal defect can also be cured with interventional catheter. The interventional treatment of these diseases is similar, mainly by cutting a small catheter with the size of 1.2 mm at the root of thigh, and accurately placing the occluder into the defect or abnormal passage in the heart or blood vessel from the right inguinal artery or vein for occlusion, and the operation is over. Plus disinfection, radiography and other procedures, the whole operation process is about 1 hour. On the second day after operation, the patient can walk on the ground and be discharged after observation 1 day.

Compared with traditional thoracotomy, interventional therapy for ventricular septal defect, atrial septal defect, patent ductus arteriosus and pulmonary valve stenosis has the following advantages: 1 No need for thoracotomy, less trauma. For children, no scar on the chest does not affect the appearance; General anesthesia and cardiopulmonary bypass are not needed, and children's physique is different from that of adults, thus avoiding the risks brought by general anesthesia and cardiopulmonary bypass; Less blood loss during operation, no need for blood transfusion; Less complications and high safety. 2. Short hospitalization time, quick recovery and no need to take any medicine after operation. Third, the treatment effect is good. 1 After the occluder is implanted in the heart, the human body's own endothelial cells cover its surface. After 3 months, endothelial cells completely embedded the occluder, and the occluder would not fall off. Interventional therapy of this kind of congenital heart disease has been improved through clinical practice and is basically mature at present. After several years of follow-up, the patients with congenital heart disease after interventional therapy have completely recovered to normal, their growth and development have not been affected, and they are competent for all work, study and life. Associate Professor, Department of Cardiology, Kongsheng People's Hospital