The most common surgery we fund is cardiac surgery to correct congenital heart disease (such as ‘hole in the heart’ and Tetralogy of Fallot). If left untreated approximately 25% of patients die within the first year of life, 40% by 4 years, 70% by 10 years, and 95% by 40 years. The children on the program with congenital heart disease constantly suffer from lack of oxygen and it is unlikely they will live more than 10 years unless donors fund their surgery.
- Patent Ductus Arteriosis (PDA): is a congenital heart condition in which the ductus, a small opening or pathway between the pulmonary and aortic valves, remains open. In young children or babies, the PDA may close on its own. However, if a PDA does not close on its own, it will require surgical repair to prevent lung problems that will develop from long-term exposure to extra blood flow.
- Atrial Septal Defect (ASD): is a type of congenital heart defect in which there is an abnormal opening in the dividing wall between the upper filling chambers of the heart (the atria). Treatment depends on the child’s age and the size, location, and severity of the defect. ASDs may be closed through cardiac catheterization or through open heart surgery.
- Ventricular Septal Defect (VSD): is another type of congenital heart defect in which there is an abnormal opening in the dividing wall between the main pumping chambers of the heart (the ventricles).
- Tetralogy of Fallot (TOF): accounts for 10% of the cases of congenital heart disease. It involves four simultaneous anomalies of the structure of the heart. Children with this heart condition often have a blue tint to their skin, lips and fingernails. This is called cyanosis and means that not enough oxygen-rich blood is reaching the child’s body. Surgery is required to correct all four defects.
- Rheumatic Heart Disease (RHD): According to the World Heart Federation, rheumatic heart disease (RHD) is the most common acquired heart disease in children in many countries of the world, especially in developing countries. RHD is a chronic heart condition that is a complication of rheumatic fever. Rheumatic Fever is caused by a group A streptococcal (strep) infection. Acute rheumatic fever can cause fibrosis of heart valves, leading to valvular heart disease. People who have had a previous attack of rheumatic fever are at high risk for a recurrent attack, which worsens the damage to the heart. Prevention of recurrent attacks of acute rheumatic fever may involve regular administration of antibiotics. However, surgery may be required to repair or replace heart valves in patients with severely damaged valves. Overcrowding, poor housing conditions, malnutrition and lack of access to healthcare play a role in the persistence of this disease in developing countries.
Treatment of children with congenital heart disease is expensive and complicated. However the prognosis is good so BCMF has many children with congenital heart defects on their program. Children up to 12 years of age have their surgery and treatment funded by Child’s Dream while other heart patients are funded directly by BCMF. Special adult cases are funded by the Burma Adult Medical Fund (BAMF) program.
Congenital heart defect is a serious condition and children usually require surgery and medication. BCMF facilitates the treatment of these children by arranging transport from the Mae Tao Clinic (on the Thai-Burma border) to Chiang Mai (350kms north-east of the border). When children arrive in Chiang Mai they visit a cardiologist to find out more about their condition. They will usually have an echocardiogram (ECHO/ECG) to provide us with an accurate assessment of their condition. Some children undergo a procedure called cardiac catheterization. This is done either to provide more diagnostic information on congenital heart disease or to repair certain types of heart defects as well as to open ‘stuck’ (stenotic) valves. Children with Tetralogy of Fallot, ventricular septal defect and pulmonary valve stenosis usually need this cardiac catheterisation.
BCMF is very pleased with the result of children who undergo heart surgery in Chiang Mai to correct congenital heart defects. Though treatment is costly and time-consuming, the long-term prospects for these children are well worth it.