Q&A with a paediatric cardiac surgeon

Written in association with: Mr Nagarajan Muthialu
Published:
Edited by: Jay Staniland

Paediatric cardiac surgery, or heart surgery in children, are surgical procedures which are done in the heart for a child who is born with congenital defects. In other terms, children born with birth defects in the heart, or in the surrounding tubes coming from the heart, are attempted to be corrected by performing various surgical procedures in such a way that these children can have a normal life.

 

What are the most common paediatric cardiac procedures?

 

The paediatric cardiac surgery field is a very vast field and children can be born with various birth defects in the heart. Some of them are simple and some of them are complex. The most common defects are found in the communications between the two sides of the heart. We know that the heart has four chambers, two of them receive blood and two of them pump blood. On the right side, the blood is pumping to the lungs. On the left side, the blood is pumping to the body.


The communications defects exist in some form between the two chambers either as an atrial septal defect between the receiving chambers of the heart, or as a ventricular septal defect, otherwise called a PDA, or patent ductus arteriosus. These are the common defects that need surgery to correct the defects in children.


Surgery is performed to correct them either using a patch or closing them directly. Those are the most common surgeries that we perform in our everyday life.

 

What are the challenges faced by a paediatric cardiac surgeon?

 

It’s very important to understand the physiology of the child and offer surgical correction at a very appropriate age. Having said this, the majority of times, we tend to correct them quite early in life and most of our surgeries are done in children in less than one year of age.


This also means it’s very important to look after these babies before surgery, during surgery, and after surgery. These surgeries are quite major lasting for a few hours for each single procedure that we perform, which means we have to look after the child in such a way that the child can return back to normal life once they recover from surgery.

 

What is the prognosis for children undergoing cardiac surgery?

 

The majority of birth defects or congenital defects in the heart are correctible by surgical procedures. Whether it is simple or complex, the surgery has evolved over the last 40 years or so, and the technology has advanced so much that almost all of the information needed in terms of understanding these defects is provided.


With this, I would wish to say that a prognosis for a child to lead a normal life, who has gone through a major cardiac surgery is very good to excellent.


Some of the children have gone on to become an excellent sportsperson, great academician, and they live a normal life into adult and very late years in life.

Mr Nagarajan Muthialu

By Mr Nagarajan Muthialu
Paediatric cardiothoracic surgery

Mr Nagarajan Muthialu is one of London's leading paediatric cardiothoracic surgeons. Based at Great Ormond Street Hospital he specialises in cardiac, thoracic and tracheal surgery, lung and heart transplantation and chest wall repair. He is heavily involved in a number of field-related areas of research including an NHS funded project for risk categorisation of paediatric and congenital cardiac surgery and has won numerous prizes throughout his medical career. He forms an integral part of various professional bodies and has been widely published in peer-reviewed journals.


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