Our Summary

This research paper discusses a model of providing cardiac care to children with heart diseases in Chennai, India, where over 90% of children worldwide without access to such care live. The model has evolved over 30 years and involves a partnership between the public and private sector. Over time, this partnership has led to a better hospital infrastructure and a highly trained team. The average cost of a heart surgery is around $2400, of which the government pays $800-$1066.67, and the rest is covered by a fund pool. The aim is to provide 100 free surgeries every year by maintaining a fund pool of around $66,666.67. This allows for fair distribution of funds without compromising on resources, and it ensures the patient is treated with dignity. The model has so far enabled 357 children to have free heart surgery, with a very low mortality rate of 2.73%. The key elements needed for this model to work are a motivated initiator, a committed surgical team, a partnership with a high-quality infrastructure, and a continuous flow of funds.

FAQs

  1. What is the model of providing cardiac care to children with heart diseases in Chennai, India?
  2. How is the cost of pediatric cardiac surgeries covered in this model?
  3. What are the key elements required for this model of pediatric cardiac care to work successfully?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric cardiac surgery is to make sure to follow all pre-operative instructions provided by the medical team, including fasting guidelines and medication instructions. It is also important to inform the medical team about any medications or supplements the child is currently taking. Additionally, it is crucial to follow all post-operative care instructions carefully to ensure a smooth recovery process. Finally, it is important to ask any questions or voice any concerns to the medical team to ensure the best possible outcome for the child.

Suitable For

Pediatric cardiac surgery is typically recommended for children with congenital heart defects, acquired heart diseases, and other cardiac conditions that require surgical intervention. Some common types of patients who may be recommended pediatric cardiac surgery include:

  1. Infants and children with congenital heart defects: These are structural abnormalities of the heart that are present at birth. Surgery may be recommended to correct these defects and improve the child’s heart function.

  2. Children with acquired heart diseases: These are heart conditions that develop after birth, such as rheumatic heart disease or cardiomyopathy. Surgery may be necessary to treat these conditions and improve the child’s heart health.

  3. Children with heart rhythm disorders: Some children may have abnormal heart rhythms that require surgical intervention to correct. This may involve procedures such as pacemaker implantation or ablation therapy.

  4. Children with heart valve abnormalities: Defects in the heart valves can lead to problems with blood flow and heart function. Surgery may be recommended to repair or replace damaged heart valves in these children.

  5. Children with complex congenital heart defects: Some children may have multiple or complex heart defects that require specialized surgical care. These children may be referred to pediatric cardiac surgeons for advanced procedures to address their specific needs.

Overall, pediatric cardiac surgery is recommended for children with a wide range of heart conditions, from simple to complex. The goal of surgery is to improve the child’s heart function, quality of life, and overall health outcomes.

Timeline

Before pediatric cardiac surgery:

  1. Diagnosis: The patient is diagnosed with a heart condition, which may be detected during routine check-ups or due to symptoms such as difficulty breathing, chest pain, or fainting spells.
  2. Consultation: The patient and their family meet with a pediatric cardiologist to discuss the diagnosis and treatment options.
  3. Pre-operative evaluation: The patient undergoes various tests and evaluations to assess their overall health and determine the best course of action for surgery.
  4. Surgery scheduling: Once the decision to proceed with surgery is made, a date is scheduled for the procedure.
  5. Preparing for surgery: The patient and their family receive instructions on how to prepare for surgery, including fasting instructions and what to expect on the day of the procedure.

After pediatric cardiac surgery:

  1. Recovery in the ICU: After surgery, the patient is transferred to the intensive care unit (ICU) for close monitoring and support. The length of time spent in the ICU varies depending on the complexity of the surgery and the patient’s condition.
  2. Transfer to a regular hospital room: Once stable, the patient is transferred to a regular hospital room to continue their recovery.
  3. Post-operative care: The patient receives ongoing medical care, including medications, physical therapy, and follow-up appointments with the surgical team.
  4. Discharge from the hospital: When the patient is deemed ready, they are discharged from the hospital with instructions on how to care for themselves at home.
  5. Follow-up care: The patient continues to receive follow-up care to monitor their progress and address any complications or concerns that may arise.

Overall, the timeline of a patient’s experience before and after pediatric cardiac surgery involves a series of steps from diagnosis to recovery, with a focus on providing comprehensive care and support throughout the process.

What to Ask Your Doctor

  1. What is the success rate for pediatric cardiac surgeries at this hospital?
  2. How many pediatric cardiac surgeries has the surgeon performed, and what is their experience in this field?
  3. What are the potential risks and complications associated with the surgery?
  4. What is the expected recovery time for my child after the surgery?
  5. Will my child require any follow-up care or additional treatments after the surgery?
  6. What support services are available for families during the surgical process and recovery period?
  7. What is the cost of the surgery, and what financial assistance options are available?
  8. Are there any alternative treatment options or less invasive procedures that could be considered for my child’s condition?
  9. How will the surgical team communicate with me throughout the process and keep me informed about my child’s progress?
  10. What is the hospital’s approach to post-operative care and rehabilitation for pediatric cardiac surgery patients?

Reference

Authors: Kim S, Seshadrinathan S, Jenkins KJ, Murala JS. Journal: World J Pediatr Congenit Heart Surg. 2023 May;14(3):316-325. doi: 10.1177/21501351221151057. Epub 2023 Feb 14. PMID: 36788012