Yetişkinlerde Kalp Deliği Tedavisi | Prof. Dr. Yavuz Beşoğul

Heart Hole in Adults, Symptoms and Treatment Methods

Cardiac perforation in adults is one of the most common congenital heart diseases. Cardiac perforation is a problem that occurs as a result of the wall between the atria or the wall between the ventricles not completely closing in the womb. This hole may be noticed at birth or after birth, but sometimes it may not be noticed until the age of 40-50. It may occur in echocardiography performed in the forties of the patient as a result of complaints such as shortness of breath and palpitations. While the hole between the atria is called Atrial Septal Defect (ASD), the hole between the ventricles is called Ventricular Septal Defect (VSD). In both cases, clean blood from the left side of the heart passes to the right side and mixes with dirty blood, increasing the amount of blood going to the lungs. Therefore, heart holes can cause some lung problems and heart problems such as heart failure and heart enlargement. It is extremely important to diagnose the disease at an early stage and apply the necessary treatment.

Article Content

What is a Heart Hole?
Heart Hole Symptoms in Adults
Heart Hole Diagnosis in Adults
Causes of Heart Hole in Adults
Heart Hole Treatment Methods in Adults
Heart Hole Surgery in Adults
Do Heart Holes Close in Newborn Babies?

1. What is a Heart Hole?

Cardiac perforation is a congenital heart disease that occurs as a result of the wall between the atria or ventricles of the heart not closing completely. In a normal heart structure, the right side of the heart deals with dirty blood and the left side deals with clean blood, and clean blood and dirty blood do not mix. In heart hole disease, clean blood from the left side of the heart passes to the right side of the heart due to a hole in the atrium or ventricle. Therefore, clean blood mixes with dirty blood and the amount of blood sent to the lungs increases. Heart hole is a disease that, if left untreated, impairs the quality of life and can cause different problems. Sometimes it manifests itself with symptoms, and sometimes it can be noticed years later in adulthood without any symptoms. This statement is something that patients are worried about and frequently ask about. Does having a hole in the heart kill you? It can be described as an answer to the question.

2. Heart Hole Symptoms in Adults

difficulty breathing
Difficulty walking
Palpitation

3. Heart Hole Diagnosis in Adults

Diagnosis of cardiac perforation in adults is made by echocardiography.

4. Causes of Heart Hole in Adults

The cause of cardiac perforation in adults is the incomplete closure of the interatrial wall or the interventricular wall in the womb. This disease, which can continue without symptoms during childhood, may occur with some problems in adulthood. Therefore, when the disease is detected, it must be treated.

5. Heart Hole in AdultsDavi Methods

In the treatment of heart hole seen in adults; Heart holes can be closed with medication, non-surgical interventional methods or, if necessary, surgical intervention. Non-surgical heart hole treatment is based on the principle of accessing the heart by entering through the groin and closing the holes using a closing device. Another method used in open surgery is minimally invasive surgery. With the minimally invasive surgical technique, cardiac puncture surgery can be performed successfully through small incisions on the side of the chest and under the armpit, without splitting the chest in the middle and cutting the sternum. In this method, the heart is reached between the ribs and the procedure is performed without cutting the bone or damaging the tissues. With minimally invasive cardiac surgery, the heart hole is repaired with small interventions from the armpit, side of the chest or under the breast. They are sewn opposite each other or a new patch is made there and the hole is closed. After the necessary tests, analyzes and evaluations are carried out by the specialist physician, the most appropriate treatment method must be decided.

6. Heart Hole Surgery in Adults

In cases where the heart hole cannot be treated with medication or non-surgical interventional methods, heart hole surgery, that is, surgical intervention, can be used. Heart holes can be successfully closed and treated with minimally invasive surgery, also known as the closed method among the public. With minimally invasive cardiac surgery, the heart hole is repaired with small interventions from the armpit, side of the chest or under the breast. They are sewn opposite each other or a new patch is made there and the hole is closed.

7. Do Heart Holes Close in Newborn Babies?

The hole between the heart chambers or the main vessels coming out of the heart, which are open in the womb of the newborn baby, usually closes with the first breath after birth or can close within 48 hours. However, some holes can be closed with follow-up because they are large or between the muscle tissue of the heart. Holes that are impossible to close and cause the mixing of dirty and clean blood require surgery first. For this purpose, minimally invasive techniques have been developed in cases of heart holes in newborn babies today.

What are the Symptoms of Heart Hole in Babies?

A hole in the heart may not cause any serious symptoms in infancy and may only appear in adulthood. However, the following symptoms may be observed in babies born with a hole in the heart:

Getting tired quickly while breastfeeding,
Bruising around the lips and face,
Inability to gain weight,
Respiratory rate too high

How is Closed Heart Hole Surgery Performed in Babies and Children?

Holes that are impossible to close and that cause dirty and clean blood to mix require surgery first. For this purpose, minimally invasive techniques have been developed today. One of these is;

It is the repair of the hole in the heart (ASD) with a 3 cm incision made under the armpit, without cutting the breastbone, and without making any incisions anywhere else in the body. With this method, the hole in the heart is repaired by cutting an average of 30-35 cm of the frontal bone (breastbone) in adults, without opening it.

Since 1997, this approach can be preferred in ASD (heart hole closure), mitral valve replacement and repair, tricuspid valve repair and aortic valve replacement and repair if the patient does not have advanced lung problems.

It is an ideal method for young, female, male, child, elderly patients and also for those with risk factors such as obesity, diabetes and heart failure.

This method was first applied to children by Japanese scientists for heart holes in 1993. In other words, it can be applied in some heart surgeries such as heart holes in children and babies.

In a patient who has had a heart surgery from the front and whose sternum has been cut open, opening the heart from the front for the second time is risky, but opening it from the side is less risky. In other words, for patients who need to have a second and third heart surgery and an ASD repair, the most ideal method is to have the surgery from the armpit. It has many advantages.

The risk of bleeding is low.
The risk of infection is low.
The recovery time is much faster.
Even the patient himself cannot see the surgery site.
Aesthetically and psychologically, the patient is as if he or she had not undergone surgery.
It does not create sexual or social problems.
After the surgery, the patient can lie in any position he/she wishes.
After surgery, the patient does not have to avoid blows to the chest.
Can drive and wear seat belt after leaving hospital.
He can use his arms as if he had never had surgery. He can lift heavy things.

What Causes a Heart Hole?

There are two congenital and non-congenital causes of heart hole:

Congenital heart hole: These are holes that form in the right and left chambers of the heart and do not close after birth, although they should.

Non-congenital heart hole: It is the formation of a hole in the middle as a result of the destruction of the area between the two ventricles after an infarction.

Does the Heart Hole Close on Its Own?

If the heart hole develops congenitally, there is a possibility of its closure in early childhood. However, if the heart hole does not close spontaneously, treatment should not be delayed. Failure to make early diagnosis and treatment causes increased lung pressure and rhythm disturbances.

What should those with a hole in their hearts pay attention to?

Although the precautions to be taken in babies, children and adults with a hole in the heart vary, the general points to be taken into consideration are as follows:

Avoiding doing strenuous activities,
Paying attention to hygiene,
Trying to protect yourself from diseases by paying attention to nutrition and sleep,
Staying away from poorly ventilated areas
Be careful that the environment is not too hot or cold

Pay attention to these items Comments of those who had heart hole surgery When examined, it is known that they go through the process more easily.

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