Definition and Overview
A heart malformation surgery consultation is an appointment with a surgeon who specialises in the surgical treatment of congenital heart disease. The appointment takes place upon the request or initiative of the patient or his family, with the primary purpose of finding out their surgical treatment options.
This consultation is a key step in seeking a surgical treatment for patients suffering from congenital defects or diseases affecting the heart, as it is sometimes the only method that can provide a long-term solution to said cardiac conditions.
Who Should Undergo and Expected Results
A heart malformation surgery consultation will benefit those who are suffering from congenital heart defects, such as the following:
- Septal defects or the presence of holes in the heart
- Narrowing of the heart valves
- Pulmonary valve stenosis
- Right ventricular hypertrophy
Unless the conditions mentioned above are diagnosed at birth, patients may seek a consultation with a cardiologist or a cardiac surgeon when they experience the following signs and symptoms of heart defects:
- Rapid breathing
- Fatigue, even with light physical activity
- Poor blood circulation
- Shortness of breath
These defects can affect different parts of the heart, from the interior walls of the valves connecting different heart chambers down to the arteries and veins that connect the heart to the rest of the body. These congenital defects can cause some abnormalities in the way the heart functions, i.e. the way it pumps blood throughout the body, thus potentially leading to serious health consequences if left untreated.
These congenital defects of the heart range from simple cases, which can cause mild symptoms, to more complex ones that can put the patient’s life at risk unless immediate surgical intervention is sought. Patients with these conditions will find a surgical consultation helpful as it will inform them about the kinds of surgeries that are available for their specific condition. Even patients who are apprehensive about undergoing surgery will feel more assured and confident about seeking treatment once they have sufficient information regarding their options.
The goals of a heart malformation surgery consultation, therefore, are to:
- Inform a patient about his existing surgical treatment options
- Educate a patient and help him compare his different options, leading up to a decision
- Inform a patient about the risks of not undergoing surgery given his condition
At the end of the consultation, a patient should be aware of all types of surgical procedures that can be used to treat his congenital heart issue and have all the information needed to make an informed decision about his health.
Aside from educating the patient about his condition and his treatment options, the surgeon can also assess the patient's overall health condition and decide if he is qualified to undergo or can withstand surgery.
How the Procedure Works
A heart malformation surgery consultation can be initiated by the patient or when a primary care provider or cardiologist who is attending to the patient’s case makes a referral. The appointment takes place in the surgeon’s clinic or office, and may last up to an hour, or longer if the patient has several questions as to how the surgery can help with his condition.
During the consultation, the surgeon will assess the patient’s current state of health by asking about any symptoms he may be experiencing as well as by looking at his medical records and previous test results. After identifying the specific type of heart malformation that the patient has, the surgeon will discuss existing surgical procedures including their advantages and disadvantages in detail. Some examples of heart surgeries that may be discussed include:
- Catheter procedures or minimally invasive heart surgery
- Open-heart surgery
At the end of the discussion, the surgeon may provide a recommendation based on his experience and expertise to help the patient make a well-informed decision about his health.
Meanwhile, if the surgeon requires additional information to assess which procedure is the most appropriate or whether surgery is safe for the patient, lab tests (such as electrocardiogram and echocardiogram) or imaging scans will be performed after the consultation.
In cases where an advanced case of heart malformation has been detected, wherein serious symptoms have already occurred, such as blood and fluid buildups in the lungs, feet, legs, and ankles, the surgeon will strongly recommend surgical intervention at the soonest possible time.
If the patient decides to pursue surgical treatment, he will be scheduled for a series of pre-operative counseling and treatment during the final week leading up to the surgery.
Possible Risks and Complications
As with all types of surgical procedures, heart malformation surgery carries a certain level of risk, despite recent improvements in the field. Patients faces a minimal risk of the following:
- Blood clot
- Blood loss
- Memory loss
- Chest pain
- Low fever
- Irregular heartbeat
- Organ damage or failure
- Chest wound infection, which is rare among otherwise healthy individuals but very common among patients who are obese or diabetic
Despite these risks, cardiologists still widely prescribe heart surgery because the risks of leaving a heart malformation untreated are known to be more severe. In fact, patients who do not seek surgical intervention face an increased risk of developing chronic medical conditions such as:
- Congestive heart failure
- Infective endocarditis
Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 62.