Pediatric Heart Expert Forum
serious heart problem
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serious heart problem

I'm from Bangladesh. My daughter is 1 month old. According to Color Doppler report by LABAID: Mitral Atresia. There is no communication between LA and LV. Hypoplastic LV. A large perimembranous  VSD seen, size-10 mm with left to right non shunt, restrictive. A large ASD-2 degree is seen, size-6 mm with left to right shunt, non-restrictive. Double outlet right ventricle. Both AO and PA coming out from RV. Malposed  Aorta. AO anterior right and PA posterior left. Moderate pulmonary valve stenosis noticed. PPG: 52 mmHg. MPA-6.6 mm, RPA-3 mm, LPA-3 mm in size. A small PDA seen, size-2 mm with left to right shunt, restrictive. Mild TR noticed. PPG: 42 mmHg. Dialated RA and RV. No coarctation seen. No intracardiac mass or vegetation seen. All other valve and tracts are normal. No pericardial effusion is seen. What would be her treatment or medicine? Does she need surgery? at what age she would need surgery? Please help us.
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Dear Zahid,

Unfortunately, what you are describing is a complex congenital cardiac defect that is definitely life-shortening without surgical intervention.  Without seeing her studies and evaluating her, I cannot tell you exactly which intervention will be needed, or its timing.  At this point, the blood returning from the lungs and the blood returning from the body is mixing.  She will need a series of surgeries to eventually separate the blood flow into two separate pathways.  Although I don’t have the information about your daughter specifically and the anatomy and physiology can vary greatly among patients, it is possible that she needs the first surgery very soon OR she may not even need the first surgery.  The second surgery is typically performed between age 4 and 6 months, and the third surgery is performed between age 1 ½ and 3 years.  These patients require lifelong outpatient pediatric cardiac follow-up, as well, but can do relatively well if they have had good surgical intervention and good cardiology care.  I do not know what is available to you in this regard in Bangladesh, but it seems that you were able to get an accurate pediatric echocardiogram, so there may be surgical services there, as well.  I wish you the best with her care.
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