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Pediatric Cardiac Surgery in Nigeria

Pediatric Cardiac Surgeries in Nigeria | Heart Surgery for Kids in Nigeria

Pediatric cardiac surgeries or Heart surgeries are performed on infants, children, and adolescents to treat heart conditions that they are either born with or acquire later in life. The purpose of these surgeries is to correct any structural abnormalities in the heart or major blood vessels, which can help the heart to function more effectively and improve overall cardiovascular health. It is estimated that more than 80,000 children are born in Nigeria with congenital heart diseases and most of these children are born in families with weaker socio-economic backgrounds. These surgeries can range from simple procedures like closing small holes in the heart to more complex interventions such as open-heart surgery, which involves repairing or replacing heart valves, reconstructing malformed chambers or rerouting blood flow. Performing these surgeries requires a highly specialized team of top cardiac surgeons, top cardiologists, anesthesiologists, and nurses to work together and ensure optimal outcomes for young patients.

Several common pediatric cardiac surgeries in Abuja and Lagos are performed routinely by the best pediatric cardiac surgeons in Nigeria to address congenital heart defects and acquired heart conditions in children in Nigeria.

Atrial Septal Defect (ASD) Repair

Atrial Septal Defect (ASD) is a congenital heart condition where there is an abnormal opening in the septum (wall) between the upper chambers (atria) of the heart. If left untreated, this opening can lead to various complications such as irregular heart rhythms or heart enlargement among children. The surgical procedure used to correct ASD is known as ASD repair. The aim of this procedure is to close the hole in the heart (atrial septum), which helps in restoring normal blood flow patterns within the heart.

Ventricular Septal Defect (VSD) Repair

Ventricular septal defect (VSD) is a hole in the wall between the two lower chambers of the heart. To correct this type of hole in the heart, a procedure is performed, which is called VSD repair. There are two primary methods for repairing VSD, however, the choice of method depends on the size and location of the VSD, as well as the overall health of the patient.

Patent Ductus Arteriosus (PDA)

While still in the womb, a baby does not require their lungs to supply oxygen because they receive oxygen from their mother. Since a baby's lungs do not supply oxygen, there is no need for the heart to pump blood to the lungs. The Ductus Arteriosus is a blood vessel that is available in all babies while still in the womb, and it lets blood bypass the lungs.

When the baby is delivered and the umbilical cord is cut, the lungs need to provide oxygen to the body. Their lungs expand and the blood vessels calm down to accept more blood flow, and the ductus arteriosus normally closes within the first hours of life. Sometimes, the ductus arteriosus does not close by itself. This condition is known as a patent ("open") ductus arteriosus. While this condition is seen more in premature babies, it may also show in full-term infants.

Fontan Procedure

This surgical procedure is used to treat complex congenital heart defects among kids, particularly cases where there is only one functional ventricle (known as single ventricle physiology). The aim of this procedure is to redirect the blood flow in such a way that oxygen-poor blood from the body bypasses the heart and flows directly to the lungs without passing through the heart's ventricles. The procedure helps improve oxygen levels in the blood and reduces the workload on the single functional ventricle.

Tetralogy of Fallot Repair (TOF)

The major function of your heart is to pump blood through the rest of your body. This blood supplies nutrients and oxygen to your body. If your heart does not work appropriately, it may not be efficient in pumping blood to other organs. This has an effect on the amount of oxygen reaching other bodily tissues. Occasionally, there are defects or problems with the heart when a child is born. These defects are called congenital heart defects among children in Nigeria.

Tetralogy of Fallot (TOF) is a congenital heart defect amongst kids in Nigeria that can be fatal if it is not treated.

Arterial Switch Operation

The Arterial Switch Operation is a surgical procedure that is used to correct a congenital heart defect known as transposition of the great arteries (TGA) in infants. In TGA, the two main arteries that leave the heart, the aorta and the pulmonary artery, are switched, which results in abnormal blood circulation in kids. During the surgery, the pediatric cardiac surgeons carefully reposition the aorta and pulmonary artery to their correct locations. This allows oxygen-rich blood to flow from the heart to the body and oxygen-poor blood to flow from the heart to the lungs, thereby restoring normal blood circulation in infants.

Norwood Procedure

The first in a series of surgeries required to improve heart function and circulation in children born with HLHS is typically the Norwood procedure, which involves reconstructing the aortic arch and redirecting blood flow to the body in kids.

Ross Procedure

Aortic valve replacement is a surgical procedure that is performed when a child’s aortic valve is damaged and needs to be replaced. This is typically caused by conditions such as aortic stenosis or aortic regurgitation. During the procedure, the child's own pulmonary valve is removed and used to replace the damaged aortic valve. Then, a pulmonary valve replacement is performed using either a donor valve or a prosthetic valve. This procedure is a long-lasting solution for young patients and eliminates the need for long-term anticoagulant medications.

Coarctation of the Aorta (COA) Repair

Coarctation of the aorta repair is a surgical procedure performed to correct a congenital heart disease among children in Nigeria where a segment of the aorta, the main artery that carries oxygen-rich blood from the heart to the body, is narrowed or constricted. This narrowing restricts blood flow to the lower part of the body, leading to high blood pressure in the arms and head and reduced blood flow to the lower body, including the abdomen, kidneys, and legs.

Truncus Arteriosus (TA) Repair

Truncus arteriosus repair is a surgical procedure performed to correct a congenital heart defect where the aorta and pulmonary artery fail to separate properly during fetal development, resulting in a single large blood vessel (truncus arteriosus) instead of separate aorta and pulmonary arteries. This condition leads to mixing of oxygen-rich and oxygen-poor blood and results in inadequate oxygenation of the body.

Transposition of the Great Arteries (TGA) Repair

Transposition of the Great Arteries (TGA) is a congenital heart defect where the two main arteries leaving the heart, the aorta, and the pulmonary artery, are switched (transposed). In a normal heart, the aorta originates from the left ventricle and carries oxygen-rich blood to the body, while the pulmonary artery originates from the right ventricle and carries oxygen-poor blood to the lungs. However, in TGA, the aorta arises from the right ventricle, and the pulmonary artery arises from the left ventricle, leading to a parallel circulation where oxygen-rich blood circulates within the lungs and oxygen-poor blood circulates within the body.

This abnormal circulation results in inadequate oxygenation of the body, leading to cyanosis (blueness of the skin) shortly after birth. Infants with TGA often require immediate medical intervention to stabilize their condition and ensure adequate oxygen supply to vital organs.

Tricuspid Atresia

Tricuspid atresia is a congenital heart defect where the tricuspid valve, which regulates blood flow between the right atrium and right ventricle of the heart, is either missing or abnormally developed. This results in the inability of blood to flow properly from the right atrium to the right ventricle and then to the lungs for oxygenation.

As a consequence, oxygen-poor blood from the body cannot flow through the right side of the heart to pick up oxygen in the lungs and then circulate back to the body. Instead, blood bypasses the poorly developed right ventricle and flows directly from the right atrium to the left side of the heart through an opening called an atrial septal defect (ASD) which are present in most cases of tricuspid atresia.

Total anomalous pulmonary venous return (TAPVR)

Total anomalous pulmonary venous return (TAPVR) is a rare congenital heart defect in children in which all of the pulmonary veins, which normally carry oxygenated blood from the lungs back to the left atrium of the heart, do not connect normally to the left atrium. Instead, the pulmonary veins connect abnormally to the right atrium or to one of its tributaries, creating a circulation pattern where oxygen-rich blood from the lungs mixes with oxygen-poor blood from the body.

As a result of this abnormal connection, oxygen-rich blood returning from the lungs is unable to flow efficiently to the left side of the heart and be distributed to the body. Instead, it returns to the right side of the heart and mixes with oxygen-poor blood, leading to inadequate oxygenation of the body tissues and organs.

Ventricular Assist Devices (VADs) or Artificial Hearts

Advanced medical devices known as VADs are used to assist individuals with severe heart failure when their own heart is incapable of pumping blood effectively. These mechanical pumps are implanted inside the chest or abdomen and take over some or all of the pumping function of the heart. They may be temporary or permanent. In contrast, total artificial hearts replace the entire heart and are implanted during surgery. They take over the heart's function completely, pumping blood throughout the body.

Heart Transplantation

Heart transplantation is a medical procedure that is typically recommended when other treatments have proven ineffective. It is usually performed on individuals who suffer from severe heart failure or other life-threatening heart conditions that cannot be treated with other medical interventions. During the surgery, the patient's diseased heart is removed, and a donor's heart is transplanted in its place. This allows the recipient to have a fully functional heart that can effectively pump blood throughout their body.

Coronary Artery Bypass Grafting (CABG)

Coronary artery bypass grafting (CABG) is a surgical procedure that is used to treat severe coronary artery disease in children. This procedure is performed when the arteries that supply blood to the heart become narrowed or blocked, leading to chest pain or angina, and increasing the risk of a heart attack. During CABG, a healthy blood vessel from another part of the body, such as the chest or leg, is taken and attached to the blocked or narrowed artery, creating a bypass route for blood to flow around the blocked area. This bypass helps restore proper blood flow to the heart, reducing symptoms and improving overall heart health among children.

Pacemaker or Implantable Cardioverter-Defibrillator (ICD) Implantation

Implantable devices are used to regulate heart rhythm in children with arrhythmias or other electrical conduction abnormalities. During a minor surgical procedure, both devices are placed under the skin near the collarbone. These devices work silently and continuously, monitoring the heart and helping it to beat normally. This provides peace of mind to those with heart rhythm problems.

Careful planning with Top cardiologists of Nigeria and post-operative care tailored to the specific needs of pediatric patients are required for successful pediatric cardiac treatment.

Understanding Patent Foramen Ovale (PFO)

A PFO is a common congenital heart defect, which means it's present at birth. It's characterized by an abnormal opening in the septum, which is the dividing wall between the upper two chambers of the heart, known as the atria. During fetal development, this opening is a normal part of the circulatory system, allowing blood to bypass the lungs, which are not yet functional. However, in most individuals, the foramen ovale closes shortly after birth.

In individuals with a PFO, this opening fails to close completely after birth, leaving a passage between the right and left atria. This opening can potentially allow blood, including small blood clots, to pass from the right side of the heart to the left side, which can travel to the brain and cause a stroke or other parts of the body, causing other complications.

The diagnosis of a PFO typically involves a combination of medical history, physical examination, and imaging tests such as echocardiography, transesophageal echocardiography (TEE), or cardiac MRI.

Treatment options for a PFO primarily focus on preventing complications associated with the condition, particularly stroke. This may involve medications such as anticoagulants (blood thinners) or antiplatelet drugs to reduce the risk of clot formation.

Cost of Pediatric Cardiac Surgery in Nigeria

The cost of pediatric cardiac surgery may vary, depending on several factors such as the complexity of the procedure, the hospital where it is performed, the region where the surgery takes place, the expertise of the medical team, the duration of hospital stay, the need for post-operative care, and any associated medical complications. For families who are facing pediatric cardiac surgery, it is important to discuss financial matters with their healthcare provider in advance.

Frequently Asked Questions (FAQs)

Q: What types of conditions do pediatric cardiac surgeries treat in Nigeria?

A: Pediatric cardiac surgeries treat a wide range of conditions, including atrial septal defects, ventricular septal defects, Tetralogy of Fallot, coarctation of the aorta, congenital heart valve defects, and more.

Q: How are cardiac surgeries in children performed in Abuja?

A: Pediatric cardiac surgeries may be performed using traditional open-heart surgery techniques or minimally invasive approaches such as transcatheter procedures, depending on the specific condition and patient factors.

Q: What are the complications of pediatric cardiac surgery? 

A: While pediatric cardiac surgeries are generally safe, they carry risks such as bleeding, infection, adverse reactions to anesthesia, arrhythmias, and, in rare cases, neurological complications. However, we have the Best Pediatric Cardiologist in Nigeria who will guide you on the risk factors.

Q: How long is the recovery period after pediatric cardiac surgery?

A: The recovery period varies depending on the type of surgery and the individual child's health. It may range from a few days to several weeks, with follow-up care including medications, monitoring, and rehabilitation.

Q: Will my child need additional surgeries in the future?

A: The need for additional surgeries depends on factors such as the type and complexity of the heart defect, the success of the initial surgery, and the child's growth and development. Some children may require follow-up procedures as they grow older.

Q: What are the long-term outcomes for children who undergo pediatric cardiac surgery in Nigeria?

A: Many children who undergo pediatric cardiac surgery experience significant improvement in their heart function and quality of life. However, long-term outcomes can vary depending on factors such as the type of heart defect, any associated complications, and the child's overall health.

Q: How can I support my child before and after pediatric cardiac surgery?

A: Supporting a child before and after surgery involves providing emotional support, following medical recommendations for preoperative preparation and postoperative care, and seeking assistance from healthcare professionals and support groups as needed.

Q: Where can I have heart surgery for my child in Nigeria?

A; Pediatric cardiac surgeries in Abuja are available at the best cardiac hospitals in Nigeria equipped with top heart surgeons in Nigeria. However, for more complex cases, children are often referred to renowned cardiac centers for children's heart surgeries in India or Egypt.

Q: How much does hole-in-heart surgery cost in Nigeria?

A: Hole in the heart is a general term for various congenital ill-formed heart structures, it will depend upon which kind of surgery is required in a particular case. Generally, pediatric cardiac surgery can range anywhere from 4 million to 15 million naira.

Q: Which hospital in Nigeria can do heart surgery?

A: Multiple hospitals across Nigeria, including specialized adult and pediatric cardiac centers in Abuja, Lagos, Enugu, and other cities, conduct these surgeries.

Q: What is the youngest age for open heart surgery?

A: The age at which a child can undergo open heart surgery depends on several factors, including the specific heart condition, the child's overall health, and the recommendations of the medical team. In some cases, open heart surgery may be performed on newborns or even infants just a few days old, particularly for critical congenital heart defects that require immediate intervention to save the child's life.

Q: Is heart surgery safe for kids in Lagos?

A: Yes, heart surgery for children can be safe when performed by the best pediatric cardiac surgeons in Lagos and the best pediatric cardiologists in Abuja. in a well-equipped hospital. Advances in surgical techniques, anesthesia, and post-operative care have significantly improved the safety and success rates of pediatric heart surgeries over the years in Nigeria.

Q: How risky is open heart surgery for kids in Nigeria?

A: It is estimated that pediatric cardiac surgeries have 86% survival rates which is quite good. However, It's essential for parents to discuss these risks thoroughly with their child's medical team and to ensure they are treated at a reputable pediatric cardiac center with expertise in treating children's heart conditions.

Q: Can we book an appointment with a cardiologist through you?

A: Yes, You can contact us and book and appointment for the best pediatric cardiologist in Abuja, the Best pediatric cardiologist in Lagos, the Best pediatric cardiologist in Kano, the Best pediatric cardiologist in Portharcourt, the Best pediatric cardiologist in Enugu and the best pediatric cardiologist in Kaduna.

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Reference

https://medlineplus.gov/ency/article/002948.htm

https://www.mayoclinic.org/departments-centers/pediatric-cardiac-surgery/sections/overview/ovc-20485994

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6777924/

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/pediatric-cardiovascular-procedures

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.114.014318

https://www.researchgate.net/publication/242334006_Quality_Measures_for_Congenital_and_Pediatric_Cardiac_Surgery

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