Complex neonatal cardiac surgery In India

Complex neonatal cardiac surgery

Cardiac defects are the most frequent congenital defects and are present in one out of every 250 child births. When a defect is severe, an operation is needed during the first weeks of life. Neonatal cardiac surgery has progressed very rapidly in the past 20 years, and is now performed routinely with very low mortality at centers like the Pediatric Heart Center at the Children's Hospital at Montefiore. Today, neonatal surgical repair in patients with two ventricles is carried out with a mortality between 0 and 3 percent, depending on the type of cardiopathy. In single-ventricle cases, the mortality remains more elevated.

Parents are welcome to stay with their child throughout the course of care. Comprehensive caring information will be provided by the medical team over the course of the hospitalization.

The neonatal cardiac surgery program collaborates with our nationally known Department of Obstetrics & Gynecology and Women's Health obstetrics department, as well as the Departments of Neonatology and Perinatology, which are all located in the East Campus of Montefiore Medical Center.

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Our Pediatric Heart Center is structured to achieve optimal results. The progress made in pediatric heart care during the past 20 years allows for the reconstruction of a nearly normal anatomy and physiology, ensuring a good long-term quality of life. For example, the complex biventricular disorders we treat include:

  • Complex transposition of the great arteries
  • Double-outlet right ventricle
  • Transposition of the great arteries
  • Common arterial trunk
  • Pulmonary atresia with ventricular septal defect (VSD) and major aorto-pulmonary collaterals

Our new technologically advanced hybrid operating room will generate other innovative procedures in the future.

The Department of Cardiothoracic Surgery at Montefiore has a robust Thoracic Surgical Program that treats a variety of different pulmonary and chest wall diseases. Board certified in pediatric cardiothoracic surgery, Samuel Weinstein, MD, performs surgery for pulmonary disease and chest wall defects in addition to his cardiac surgical practice.

The airway team at the Children's Hospital at Montefiore (CHAM) frequently treats patients with complex tracheal disease that require major surgical therapy. The group at Montefiore has extensive experience with tracheal resections and slide tracheoplasty, a new technique that treats even the most severe form of tracheal stenosis, complete tracheal rings.

In addition to tracheal surgery, Dr. Weinstein treats patients who have pulmonary tumors, metastases to the lungs, or mass lesions of the chest wall. Working closely with Richard G. Gorlick, MD, and the Division of Pediatric Oncology, patients who require adjuvant chemotherapy or radiation will have their care closely monitored and coordinated so that surgery will yield the best outcomes. The Pediatric Computed Tomography department and the Division of Pediatric Oncology work closely together to provide family-centered care for every child battling with cancer.

The intensive care unit and the pulmonary, radiology and infectious disease departments at CHAM support an aggressive program that treats children who have pneumonia that is failing to improve with medical therapy. Children with pneumonia who fail to respond to antibiotics quickly can suffer complications such as an abscess in the lung or an empyema, an infection in the chest cavity. The team at Montefiore evaluates these patients with ultrasound, a technique that is not only painless but also avoids radiation exposure for the child. When complications of pneumonia are detected, the surgical team treats the patients with video-assisted thoracic surgery (VATS), a minimally invasive approach. Patients who might have spent weeks in the hospital can usually go home in just a few days after a VATS procedure. Children with complications of pneumonia are transferred to CHAM routinely from around the region for such therapy.

Pectus excavatum and pectus carinatum are common defects of the chest wall affecting both young children and adolescents. The thoracic program at CHAM coordinates care of these patients between the pulmonary department, psychology department and surgical division. Performing the modified Ravitch procedure, surgeons at Montefiore have extensive experience with this lesion, which affects not only children's bodies, but also how they view themselves at a key time of development. Dr. Weinstein has published his experience and philosophy on treating children with this condition (Ann Thorac Surg. 2004;7