My daughter was born with an Atrial Septal Defect of the heart ( ASD ) about 14 years ago. She is my first born and the event was one of mixed emotions. When I was told by her pediatrician that he suspected something could be wrong with her heart but was not very sure, I was stared at him in dis-belief as my daughter have the pink of health look. I am not sure if it helps that her pediatrician also actor on national TV occasionally as a hobby that I thought he was pulling my leg. His serious look says it all. I am very glad that he had the humility and bed side manners to inform me that he does not know enough about this area and would refer me to a pediatric cardiologist for further investigation. Before the door close behind us, he told me to take it easy for the time being as he is not very sure himself.
I took the earliest possible opportunity to see the pediatric cardiologist and although the wait was only the next day, it seems an eternity. Did not help that the clinic was pack on the day itself and there was a further wait at the clinic that was partly our fault as we arrived too early in all eagerness I think.
When our turn came to see the specialist, he read the referral letter and said let me have a listen at her heart and I kept intently quiet and it helped that my daughter was able to stay still for him to hear her heart properly through his stethoscope. My parents were outside the consult room in all anxiousness as she is their first grandchild and the jewel in their eyes. After the several moment to golden silence, he sat back and started speaking. He told me that he did hear something unusual but that the stethoscope is not the most accurate instrument for this and would proceeded with a cardiac echo gram after we have sedated my daughter followed by an ECG and some blood test.
While inside the echo gram room, I could see him moving a probe lined with jelly like cream and watching screen and hearing the sound of the heart and speaking in some strange language to his nurse aide who was taking his dictation. It took about 20 minutes and came the news that he had seen an ASD of about 5mm in my daughter's heart. He re-assured us that there is no near term danger and told us about the standard ASD precautions that have to be taken for my daughter. On treatment options, we were given the do nothing for now and monitor closely through monthly followed by quarterly and then yearly checks. The other option was to close the whole using open heart surgery which was the only option at the point in time and given the size and the fact that it was largely asymptomatic in my daughter's case, it was not worth the risk of open heart surgery. Moreover, there was some chance of the hole closing by itself.
In all these years, the periodic monitoring has been an emotional roller coaster ride as the reading went from 5 mm to 15 mm and we also witnessed the progression of echo gram technology as it went from monochrome to color and grew in sophistication.
When my daughter reached teenage, I can see that she love sports and outdoors activities quite a fair bit and did not feel that life has been fair to her to not be able to participate fully in these activities and some of which she is quite good at in my opinion. After further considerations and the availability of a safer method to close up the ASD, decision was reached together with my daughter as I believe very much in democracy and practice it at home with my two kids to the dis-quiet of some parents in my part of the world. The pros and cons were discussed, debated and googled on no end until we decided to take the decision.
On the day of the surgery, it was done though a minimally invasive procedure. After measure of the size, shape and location of the ASD using a catheter, the cardiologist came of out of the surgery room to inform that the hole is about 7mm and fairly regular sized and a good candidate to closure using a 15MM device. We agreed and the device was implanted into her heart to close her ASD through a catheter. She was sent to the ICU as a standard procedure after the procedure for a few hours of monitoring and by about 2pm, we were talking to her through she was a bit dazed from the after effects of general anesthesia considering that she had the procedure done at 8am the same day. Just before dinner the same day, she was transferred back to a normal ward and was heartily having her dinner. Being a foodie herself, we took her additional orders for special food especially of donuts, cup cakes etc. She had two lady classmates at her bed side during dinner and they were having the usual teenage chatter to no end and parents were secondary. She was discharged the next day noon after echo gram by doctor and the operation site for the minimally invasive procedure was healing well. She spent the next 10 days at home more so as a precaution as school can be a bit of a challenge as her high school has kids of between 12 to 18 years old and it is not very easy to prevent physical knocks.
Today marks the 15th day of her surgery and she is like any normal child and in about six months time if her own heart tissue grows over the device properly to anchor it in place, she is good for a fully normal life except for some precautions relating to MRI.
I am sharing as a sort of patient emotional support effort for patients with similar situations from a real life account. I am not a doctor and therefore, what is shared is purely from a layman parent perspective. The second reason for sharing this is also to thank her two cardiologists that took care of her. The first one starting when she was a baby and the second one that did the closure procedure for her. Oh we must not forget about the pediatrician that acts for a hobby who started us on this healing journey. It so happens that both cardiologists have a common family name YIP. I am not at will to disclose their names as I have not obtained prior permission. When the 3 doctors read this and if you recall, a special thank you to from patient and parent and our heart felt thanks for the good clinical care, rational advice and emotional support.
Cheers,,, Pete