What Makes a Good Paediatric Cardiac Surgery Programme

Approximately 5,500 USD.

For TGA with VSD and LVOT obstruction, these kids essentially have pulmonary stenosis with a VSD, and timing depends on the kid's oxygen saturation — they will need a Rastelli or a Nikaidoh operation, both requiring an implant, and the intent is to give the biggest implant possible since a smaller implant means an earlier return for a change. If saturations are above 75% and the kid is growing and doing well, they can wait and have surgery at around one year of age; if saturations are less than 75% with significant failure to thrive, they should come for surgery at any age or weight. On late presenters: we are also a resource-limited country — four or five surgeons doing this work for half of India — and face the same problem of kids coming late every day. My suggestion is education programmes, including pulse oximeter screening at birth, 1 month, and 6 months, referring for an echo early if abnormal. Late-presenting PDAs and cyanotic conditions apart from TGA are usually still operable, even if at slightly higher risk, but VSD shunt lesions can become inoperable if too late — however, even when a kid looks clinically inoperable, we always offer a cardiac catheterisation to confirm, since a significant proportion will still turn out to be operable, if high risk. And even an inoperable VSD child, with good, appropriately timed medical management (diuretics, pulmonary vasodilators), can still survive 25–35 years, whereas without that care they will die much earlier.

Nine criteria set out by the British Medical Journal, covering surgical outcomes as well as supporting specialist services such as heart failure clinics, fetal cardiology, and pulmonary hypertension care.

Heart failure clinics, fetal cardiology clinics, pulmonary hypertension clinics, arrhythmia and pacemaker services, adult congenital heart disease clinics, heart valve clinics, and advanced options such as heart transplants, paediatric ventricular assist devices, ECMO, and cardiac resynchronisation therapy.

A pathway that allows babies with a fetal diagnosis of a heart condition to be delivered under the care of the paediatric cardiac team, moving directly into the paediatric cardiac intensive care unit for treatment and surgery before going home, avoiding the delays that come from diagnosis after birth.

Artemis Hospitals is the first hospital in Delhi NCR to receive JCI accreditation, and is supported by a team of 40 healthcare providers across paediatric cardiology and cardiac surgery, within a hospital of more than 750 beds, 12 centres of excellence, and 400 doctors.