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Home  | Conditions | Complex Heart Defects

is a leading senior consultant in Paediatric Cardiology and specialises in Echocardiography and Interventional Cardiology.

COMPLEX HEART DEFECTS

Congenital heart disease comprises a spectrum of defects of the heart present at birth. These defects occur during development of the normal heart in the womb even before babies are born. The crucial period of heart development is in the first 4 weeks of the heart development in womb when it changes from a simple tube like structure to form a complex efficient structure with a pump like action, valves and tubes that carry blood to the entire body and lungs. Although present at birth, on some occasions, congenital heart disease is picked up in later life.
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Congenital heart disease can vary from simple defects such as holes in the heart (atrial septal defect or ventricular septal defectpatent ductus arteriosus), diseases of the valve (aortic valve stenosispulmonary valve stenosisbicuspid aortic valve), narrowing of arteries (coarctation of aorta, pulmonary artery stenosis) or complex abnormalities of connection (Tetralogy of Fallot, transposition of great arteries, double outlet right ventricle, total anomalous pulmonary venous drainage) and severe anomalies (tricuspid atresia, hypoplastic left heart syndrome, single ventricle circulations, isomerism with unbalanced ventricles).
 
Tetralogy of Fallot or coarctation of aorta are complex heart conditions with a combination of defects. They often need more than one procedures and life-long follow up.

TETRALOGY OF FALLOT

This condition describes 4 defects of various degrees that occur in combination:
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1. Pulmonary stenosis – obstruction of flow to lung circulation (can occur at various levels)
2. Ventricular septal defect– hole between the pumping chambers
3. Over-riding of aorta- the main body artery sits astride both pumping chambers to various degree and sometimes may arise mainly from the right pumping chamber
4. Right ventricular hypertrophy – thickening of the right pumping chamber

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Dr Khambadkone can perform balloon dilation of pulmonary valve or right ventricular outflow tract stenting (RVOT stent) by a key hole technique of cardiac catheterization. The allows better flow to be established to the lung circulation until a definitive surgery can be arranged.

COARCTATION OF THE AORTA

Coarctation of aorta means narrowing of the main body artery. Any narrowing of this artery increases the burden of work on the heart. This can affect its function from causing weakening of heart muscle and heart failure or increased thickening and stiffening of heart muscle affecting its filling with blood.
 
Definitive treatment is with surgery and Dr Khambadkone works closely with renowned cardiac surgeons who will perform the surgery. When babies or infants are very sick or if the risk of surgery is high, balloon angioplasty by cardiac catheterisation is used to improve the circulation, with surgery at a later stage, if there is recurrence of persistence of narrowing.
 
Dr Khambadkone has the expertise and experience to perform this.

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