Surgeon Ditkovsky: In half of the cases, children with congenital heart disease charity organizations

The Rinat Akhmetov humanitarian centre has launched a new project of targeted assistance to “Healthy heart”. Thanks to the installation of the occluder is a special device that allows you to close the interventricular septum of the heart — Donbass children with congenital heart defects will get the chance to return to a normal healthy life. Endovascular surgeon Institute. N. M. Amosov, Igor Ditkovsky told about the benefits of operations with the use of occluders.

— Igor Aleksandrovich how the number of children in our country suffer from congenital heart defects and need surgery?

— According to statistics, born in Ukraine every year about 4.5 thousand children with heart defects, of which 600-700 in the Donetsk and Lugansk regions. In Ukraine — only half of children with congenital heart defects receive timely medical assistance, the debt reaches tens of thousands of people. After all, it can be not only children, but adults with heart problems who have not sought help.

In the framework of the project “Healthy heart” by Rinat Akhmetov humanitarian center provides assistance to children of Donbass with the diagnosis of “patent ductus arteriosus” and “secondary defect of interatrial septum”. What doctors recommend in such cases?

Children with such diagnoses recommended endovascular surgery with the use of occluders. I want to note that this is the most modern and less traumatic method of treatment.
Surgery is also very effective. There are heart diseases in which it can not be avoided. But now the whole world is committed to ensuring that these operations were the least traumatic for the child. And Ukrainian children deserve to be treated according to international standards and have the right to a long, happy and healthy life.

— Why is it so desirable surgery?

— Surgical abdominal surgery — injury to the body. Not so hard to sew a small defect in the heart, how to reach him. The surgery is performed under General anesthetic. The surgeon makes an incision into the thorax. Child hooked up to a machine that replaces the heart and lungs. After this the heart is purified from blood, and the doctor removes the defect. As a rule, the closure of the defect is a matter of minutes. But the anesthesia, the connection, the cut is a long and very traumatic process.

— What is the advantage of operations with the use of the occluder?

Endovascular method has the least complications. This surgery is done without incisions, no scalpel. We pierce the large vessels in the thigh and through a long thin catheter to penetrate to a problem location. The catheters are delivered occluder device is made of special material which can be stretched into a long tube and take the form of umbrella size of up to 4 cm When the umbrella reaches the hole in the interatrial septum, the doctor opens it and locks in the hole. Over time, connective tissue grows into it, and the occluder becomes part of the heart.

Do you need anesthesia during endovascular surgery?

— In children older than five years, the majority of such operations performed under local anesthesia. We ask them to lie down for 15-20 minutes and watch cartoons. And kids do shallow anesthesia. The kids don’t even know what’s going on. One little prick and they fall asleep at mum on hands. Only then we do surgery. Upon completion of benthem leg, and the baby wakes up again with mom. This is similar to conventional vaccination in the clinic.

— Do you need children rehabilitation after endovascular surgery?

— During this surgery, the child receives no physical or psychological injury. 90% of our little patients go home the next day. We only ask parents to slightly restrict physical activity of the child in the first month after surgery. The medication is assigned to the aspirin, and then only with the atrial septal defect.

— What happens then?

— Child returns to normal life. There are certain rules which should adhere to the following six months. But physical activity and a child’s life is not affected. Why six months? During this time, the occluder fused with the body. The essence of these devices is to create some kind of sealed the patch between the Atria. This is a special carcast that allows you to grow your atrial septum. Karkosik grows into the septum for a lifetime and not need replacement.

— How important is it to eliminate heart disease in early childhood?

— Unfortunately, we are often faced with advanced heart disease. Among the reasons is late diagnosis, the reluctance to be treated. It also happens that parents are afraid to do the surgery to your child. Some come to us too late and we are forced to refuse treatment. These people are already disabled. They are shown a heart transplant. The best age for treating autism spectrum disorder — preschool. This defect, which is not a critical. With it the child can develop and grow normally. He requires no medication, no limitations to physical activity. But in the period from 2 to 5 years, this operation should be done. This leads to the best results.

— And in the case of open arterial duct?

— In the case of open arterial (known to inhibit) duct there are indications that require emergency surgery. Those which lead to increased pressure in the lungs, in consequence of which there develops multiple sclerosis. This process is irreversible and the child may be disabled. Children should undergo regular echocardiography, in order not to miss a moment of the timely closure of the duct. At the end of last year we were approached by a family from Donbass with such a situation. It was about the life of a child. In a matter of days the Rinat Akhmetov Humanitarian centre has allocated funds for the purchase of the occluder, and duct botallov was closed. Now everything is fine.

— Are there any disadvantages in carrying out endovascular surgery?

— The most proper and gentle method is endovascular surgery. But this method is expensive. The cost of the occluder reaches 100 thousand hryvnias. Many parents are unable to collect the necessary sum for the operation.

— Given the high cost of occluders, tell us whether the state is funding this work? And who helps sick children?

— In this direction, help is minimal, in 2016, our Institute purchased four of the occluder with the participation of the state. Devices is not enough. In half of the cases, children with congenital heart disease charity organizations. Only last year we conducted operation seven children from the Donetsk and Lugansk regions thanks to the help of Rinat Akhmetov. Remember 13-year-old violet with her mother, immigrants from the Donbass. Heart disease they found after came to us for consultation. The staff promptly helped so that violet’s mom the day went home with a closed duct. Thank you Gustavo for this help. This is an important and good deed. Cardiac surgery — high-tech and expensive branch of medicine, and endovascular surgery — its peak. Money is sorely lacking. Therefore, the assistance provided by the Rinat Akhmetov humanitarian center is very important for us and for all the children of Donbass.