Cardiac Surgery

• Ventricular Septal Defect (VSD) surgery often involves widening the pulmonary valve for several reasons: to improve blood flow to the lungs, prevent right ventricular hypertrophy (RVH), improve long-term outcomes, prevent future interventions, and balance the pressure between ventricles.
• VSD allows blood to bypass the lungs and flow directly from the left ventricle to the right ventricle, reducing the blood flow to the lungs and potentially leading to cyanosis (blue discoloration of the skin) and other problems.
• In VSD repair, widening the pulmonary valve allows more blood to flow from the right ventricle to the lungs, correcting the cyanosis and improving oxygenation.
• Right ventricular hypertrophy in VSD: Right ventricle has to work harder to pump blood through the narrowed pulmonary valve, which can cause the muscle to thicken and enlarge, a condition known as RVH.
• In VSD repair, widening the pulmonary valve reduces the workload on the right ventricle, preventing or reducing RVH.
• RVH can lead to heart failure and other complications later in life, making widening the pulmonary valve during VSD surgery important for long-term outcomes and reducing the risk of complications.
• In some cases, a narrowed pulmonary valve may require additional procedures later in life, making widening the pulmonary valve during VSD surgery significant in preventing future interventions.
• In VSD repair, widening the pulmonary valve helps to equalize the pressure between the left and right ventricles, which improves the overall function of the heart.
• Pleural effusions are a specific complication of the Fontan procedure, characterized by the buildup of fluid in the space around the lungs, causing respiratory distress.
• Chylothorax is another specific complication of the Fontan procedure, involving the accumulation of lymphatic fluid in the chest cavity, similar to pleural effusions.
• Arrhythmias are a potential complication of the Fontan procedure, requiring monitoring and potentially medication or other interventions.
• Following the Fontan procedure, bleeding can occur at the incision site or internally, and requires close monitoring and prompt management.
• Infection is a potential complication of the Fontan procedure, with surgical site infections and pneumonia being potential complications.
• Protein-losing enteropathy (PLE) is a late complication of the Fontan procedure, involving leakage of protein from the intestines into the stool, leading to malnutrition and other problems.
• Plastic bronchitis is a late complication of the Fontan procedure, involving abnormal thickening and scarring of the airways, causing coughing, wheezing, and shortness of breath.
• Renal complications can occur in children with Fontan circulation, as changes in blood flow can affect kidney function over time.
• Children with Fontan circulation require lifelong follow-up care with a cardiologist to monitor for complications and manage their health.