JAKAYA KIKWETE CARDIAC INSTITUTE (JKCI)

Cardiology Services

Correcting Transposed Large Arteries In Heart With Arterial Switch Operation With Expert Hands

Introduction

Among the major congenital heart diseases, which are usually evident from a very early age, the one that requires arterial switch operation is that of the opposite placement of the large arteries, which go out from the heart. Transposition of the great arteries is the congenital heart condition, where the positions of the aorta and pulmonary artery are not coming out from the left ventricle and right ventricle respective, which is the normal case. Instead, the right ventricle pumps blood into the lungs through aorta and the pulmonary artery takes blood from left ventricle into the rest of the body.

In this kind of heart condition, the chambers of the heart are as in normal. But, even this kind of transposition doesn't become compatible with life for more than a few years. In the arterial switch operation, typically there is change in the morphology of the right and left atrium, so that they communicate with the ventricles that pump blood into the pulmonary artery and to the aorta.

So, after the arterial switch operation, there is pumping of blood into the pulmonary artery through left ventricle with connection to the right atrium, while the left atrium is opened into the right ventricle, with the help of artificial valves, for the blood to be pumped into the aorta from the right ventricle. In this way, there is virtual correction of the flow of blood. Arterial switch operation is actually an open heart surgery, which requires expert hands. For this reason, ASO in Tanzania is done only at JKCI with suitable arrangements and with heart-lungs machine availability.

Requirements for Arterial switch operation

Arterial switch operation in India is done in renowned cardiac centres, where advanced set up is available. The team of cardiologists, cardiothoracic surgeons and anaesthetists with suitable experience in cardiac surgeries are required to be part of this operation in Tanzania. Patients are usually of very young age, because this condition is detrimental for longer life and hence the correction has to be done when the kid is of only a few weeks. This allows the blood flow to be maintained, before the blood requirements of different organs are adjusted.

Procedure of Arterial Switch Operation

Prior to the performing of operation, the child is given transfusion, and more blood is required for maintaining the heart and lung functions. Anaesthesia is also given just before the operation. The operation itself is quite elongated, usually taking more than 6 hours or so, and the child will be shifted to a cardiovascular intensive care unit after the operation. In Tanzania regular check is being done and the patient is followed up after the surgery, so that the heart functionality is properly maintained and there is proper recovery.

During the surgery of arterial switch operation in Indian cardiac centres, the surgeons are very careful in creating new channels. It is a very intricate work, involving plenty of arteries and veins. These are to be first observed intra-operatively and then the suitable branch selections are made. These are then removed and some of the branches are left back for muscular supply. But, the great arteries to the lungs and to the other parts of the body are transacted and juxtaposed at the respective ventricles, so that the blood flow occurs towards the proper sides. With the facilities for arterial switch operations available in India, people from even outside the country are opting for this operation, because of the high success rate and good prognosis after the surgery. In this operation, sometimes other congenital conditions, if present, like that of Arterial Septal Defect or ASD can also be corrected. Besides, the recovery from the process is also quite satisfactory, only if done under proper supervision and process.

Benefits to the patients from the arterial switch operation

For conditions like that of the juxtaposition of the heart arteries, especially the larger ones coming out from the ventricles, the arterial switch operation is one of the most efficient because about 96% of patients can lead a normal life. With the advanced set ups available in most of the hospitals in the present day scenario, it is possible to have the right pre-operative care, intra-operative and post operative care. This is a benefit for the patients, and the parents are happy because they get good correction of the juxtaposed arteries in very economical costs. This facility is also available in good set ups which can provide them with the solutions.

Benefits of the Arterial Switch Operation are based on the type of facilities available, the skill and mastery over this kind of operation of the surgeon and the patient's health conditions. In most of the Indian hospitals, the operation is being done by reputed cardiologists, along with highly advanced diagnostic tests, which increases the percentage of success. There has also been a reduction in various kinds of cardiology operations in India, for which one can get the operations done with lower costs, compared to many of the foreign hospitals. This enables people in India to get best quality care and operations in the country and even many foreign people come to India for arterial switch operation in Indian hospitals.

Medical facilities and reasons to avail the arterial switch operation in Tanzania

The Jatene procedure or arterial switch operation or ASO is being done in some cardiac centres abroad. So, people need not go outside the country searching for the hospitals where ASO is being done. If done in Tanzania, arterial switch operation costs quite less. Doctors handling such operations are well trained, experienced and have plenty of skills required to diagnose and treat these cases. Since the children undergoing these operations are quite young, parents are very much concerned about the safety and prognosis of the operation. When arterial switch operation is done in Tanzania, parents are much relieved, because they have the assurance of best services in terms of operation procedures, skill of doctors and the advanced ICU set ups to handle these kinds of post operative management for transposition of the great arteries.


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