It is not necessary to have surgery for all cases of heart murmurs because, most of the time, it is a benign situation and one can live with it normally without major health problems.
In addition, in infants and children, it is very common for the breath to last only a few months or years and to resolve itself naturally, as the structures of the heart are still developing.
Thus surgery is indicated in cases in which the murmur is caused by a disease of the muscles or heart valves that disrupts its functioning, such as a severe narrowing or insufficiency, to the point of causing symptoms such as shortness of breath, tiredness or palpitations, for example. Understand better what is and what causes the breath in the hearts of adults and children.
How is the surgery done
Surgery to correct heart disease is indicated by the cardiologist and cardiac surgeon, who jointly decide the best type of surgery to change each person.
Often prior to surgery, treatment with medicines to improve the condition and control symptoms may be attempted with the use of Hydralazine, Captopril or Furosemide, for example, which may be useful for some people. However, when the symptoms are severe or do not improve with medication, the surgical procedure may be the best alternative to improve the quality of life of the baby or the adult.
To program the surgery, a preoperative evaluation is performed, with a battery of blood tests, such as hemogram and coagulogram, and imaging, such as echocardiogram, electrocardiogram, chest X-ray and cardiac catheterization, for example.
Types of Surgery
Surgery for both the child and the adult is done according to the defect in the heart that must be corrected, which can be:
- Narrowing of the heart valve, which occurs in diseases such as mitral, aortic, pulmonary or tricuspid stenosis: balloon dilatation can be done through a catheter that is inserted into the heart and inflates the balloon to the exact location, or by surgery, in which opens the heart for correction of the valve or, in some cases, is exchanged for an artificial valve;
- Insufficiency of the valve, which occurs in cases of mitral valve prolapse or valve insufficiency, such as aortic, mitral, pulmonary and tricuspid: surgery can be performed to correct the defect in the valve or the valve replacement by an artificial valve;
- Congenital heart disease, as in infants with interatrial (CIA) or interventricular (IVC) communications, persistent ductus arteriosus, or tetralogy of Fallot, for example: surgery is performed to correct the defect in the heart muscle.
In most cases, a single procedure is needed to improve heart function and reduce symptoms, however, in more complicated cases, more than one surgery may be needed.
How to Prepare for Surgery
For surgery, a fasting period is required, which varies with age, with an average of 4 to 6 hours for infants and 8 hours for children over 3 years and adults. The procedure is done under general anesthesia, and the duration of the surgery depends on its type, but varies between about 4 to 8 hours.
Surgery Risks
Any cardiac surgery is delicate, since it involves the heart and blood circulation, however, the risks are currently low because of the new technologies of medicine and surgical materials.
Some complications that can hardly happen in cardiac surgery are bleeding, infection, infarction, cardiac arrest or valve rejection, for example. These types of complications can be avoided by performing a well-done pre and post-operative following all doctor's guidelines.
How is recovery
After the surgery, the postoperative period is done in the ICU for about 2 days, and then the follow-up happens in the ward room, where the child or adult can stay for about 7 days, with evaluations by the cardiologist, until the discharged from hospital. During this period, in addition to the use of medicines for discomfort and pain, such as Paracetamol, physical therapy may be initiated for strength and breathing rehabilitation after surgery.
After discharge home, you should follow some guidelines, such as:
- Use the medicines prescribed by the doctor;
- Make no efforts except those recommended by the physiotherapist;
- Have a balanced diet with a diet high in fiber, fruits, vegetables and whole grains, such as oats and flaxseed, and avoiding fatty or salty foods;
- Go to return visits with the cardiologist for reevaluations;
- Anticipate the return or contact the doctor immediately in cases of fever greater than 38ºC, lack of intense air, very strong pain, bleeding or pus in the scar.
Learn more about recovery from childhood heart surgery and and from adult heart surgery.
