In closed-heart surgeries, it is still necessary to open the chest, but not to stop the heart or using the heart-lung bypass machine. Most closed-heart procedures deal with major blood vessels, such as the aorta or pulmonary arteries. Let us take a look separately in the two kinds of close heart surgeries- Corrective and palliative surgeries.
In patent ductus arteriosus condition, first medicines are used for the closure and if it does not work then other corrective methods are used.
The surgeon can make a cut in the groin and insert a catheter into the infant’s ductus arteriosus artery. Through this a small metal is inserted to block the blood flow and the problem is corrected.
In another kind, a small surgical cut on the left side of the chest is done. Once the PDA is located the surgeon ties or clips or divides and cuts it.
To repair coarctation of aorta, patient can be treated by cutting the narrow section and make it bigger with a patch which is synthetic in nature.
The second way to deal with this problem is to cut the narrow region and stitch the remaining ends.
The third way would include subclavian flap where after cutting the narrow part, a patch is taken from the left subclavian artery to make that portion large.
In a fourth way, a tube is connected to the normal sections of the aorta on both sides of the narrow region so that blood can flow normally.
Another non-invasive method is inserting a stent with a balloon at the tip to help open the artery at the constricted region.
To repair the ASD surgeon makes a cut in the groin and inserts a blood vessel to access the heart. Two devices shaped like umbrellas are implanted on the right and left sides of the septum. They are attached to each other to close the holes.
To repair VSDa patch can be placed on the hole via a stent inserted through the groin of the patient.
To repair Tricuspid valve defect series of shunts and surgeries may be required to allow the blood to flow into the lungs. For this surgeon may require repair or replace the tricuspid valve or insert a shunt to allow blood to get into the lungs.
To repair a hypoplastic left heart, three series of surgeries may be required. In the first, one vessel is formed from the aorta and pulmonary artery. This new vessel is responsible for carrying blood to the lungs. Second one is called Fontan operation and is done when the baby is 4 to 6 months old. While the third must be done a year later from the second. The series of operations are considered to be quite complicated.