Definition and Overview

Patients who have undergone surgery to correct a heart malformation or congenital heart defect are automatically scheduled for a follow-up visit with their surgeon and primary care provider.

Showing up for all post-surgical follow-ups have played a key role in preventing potentially serious complications that may arise from such a sensitive procedure. Thus, no matter how long a surgery has been, patients who have had their hearts repaired through surgery are strongly encouraged to stick to the long-term follow-up care plan to ensure their health.

Who Should Undergo and Expected Results

A heart malformation surgery follow-up is an important part of post-surgical care for patients who have undergone heart surgery. These include patients of any age, from babies who are given corrective heart surgery at an early age to adults who seek surgery at a later time due to worsening symptoms caused by their mild congenital heart defects.

The follow-up is scheduled for all patients regardless of the type of malformation they had or what type of surgery they underwent.

Some examples of heart malformations that can be treated with surgery include:

  • Aortic valve stenosis – Surgery to repair this type of heart defect is scheduled depending on the severity of the problem, i.e. how narrow the valve is. If a baby has abnormally narrow valves, the surgery may be scheduled earlier. If not, the surgery can wait until the baby is older. This problem can be treated with a balloon valvuloplasty.

  • Pulmonary valve stenosis – Surgery is an important part of the treatment plan for patients suffering from this disease, which places them at risk of heart failure at a later point in time if the condition is left untreated.

  • Single ventricle defects – Surgery for the treatment of these defects may take up to three stages, with the first stage best performed shortly after birth and the second when the child reaches four to six-year-old. This is followed by a third and final step, which is scheduled between 18 and 36 months after the second stage.

  • Ventricular septal defect - Surgery only becomes necessary if the hole is too big.

  • Coarctation of the aorta – This is characterized by obstructed blood flow through the aorta, so the surgery is usually scheduled as early as possible. The procedure to treat this problem is similar to a coronary artery bypass graft.

Heart malformation surgery may involve any part of the heart, and may be performed using different techniques, such as:

  • Cardiac catheterization – Catheter-based surgeries are safer, less invasive procedures wherein a catheter is inserted through a small incision made on the patient’s skin to facilitate the surgery. The development of this technique has made heart surgeries safer and more feasible for infants, allowing parents to have their child’s heart malformation resolved immediately after birth.

  • Open-heart surgery – Known as the traditional type of surgery for heart malformations, an open-heart surgery is performed with the heart completely exposed. These days, with the availability of catheter-based procedures, open-heart surgeries are only performed for more serious cases.

Several other types of surgeries are used to repair very specific malformations. All patients who undergo these procedures should come back to their surgeon’s office or clinic for their scheduled follow-ups.

The purpose of the follow-up visit is to:

  • Assess the patient’s condition and make sure he is recovering well
  • Compare the patient’s current condition to that before the procedure
  • Evaluate the results of the procedure to determine whether it was effective or not
  • Make sure no risks, complications and side effects have occurred
  • Determine the next appropriate steps for the patient

How the Procedure Works

In most cases, heart malformation surgery follow-ups are scheduled following the procedure, and patients are advised to keep these appointments in order for them to receive the best level of care from their medical team. The first follow-up appointment is scheduled within a week after the patient is discharged from the hospital and this typically lasts less than an hour. The schedule is given as part of the discharge instructions from the attending doctor. After this, the second follow-up appointment is scheduled around the 8th week following the procedure.

During the follow-up visit, the doctor will conduct a thorough physical examination to check on the patient’s current health and will ask how the patient is feeling, if possible. In paediatric patients, the doctor will ask about the parents’ observations regarding their child’s symptoms and behavior before and after surgery. The doctor will then check for signs of complications.

If no problems are found, the cardiologist will provide the patient with helpful instructions on physical activity, diet, work and medications. At the end of the visit, he will provide a long-term care plan, which will specify when the patient should return for his regular follow-up visits. These are scheduled at least once a year and are very important in maintaining the long-term health of patients who underwent heart surgery.

Possible Risks and Complications

To avoid any risks and complications from arising, patients who undergo a health malformation surgery should take their follow-up appointments very seriously and should follow their doctors’ guidelines on maintaining proper health. Doing so will help protect the patient from possible risks and complications that are linked to heart surgeries, which include:

  • Infection
  • Infective endocarditis
  • Delayed allergic reaction to the anaesthesia
  • Bleeding
  • Blood loss
  • Blood clot
  • Organ failure
  • Stroke
  • Heart attack
  • Memory loss
  • Chest pain
  • Low-grade fever
    Reference:

  • 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.

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