VietNamNet Bridge – Some 9,200 infants are born with a form of heart disease every year, of which more than 3,000 cases are classified as serious conditions. The number has also risen in recent years, according to head of the Cardiovascular Department of the HCM City Pediatrics Hospital No.1 Vu Minh Phuc.

A doctor checks a child's heart rate at the Ha Noi-based Bach Mai Hospital. The number of new-borns with heart disease has risen recent years.

Speaking at a conference to address issues relating to infant heart disease, Phuc said many of the newborns with heart disease must undergo treatment or surgery within the first two or four weeks.

He said the rise in the number of cases was due to better diagnostic capabilities and inferior pregnancy monitoring.

"If pregnancy monitoring is done properly, the rate of infants with heart diseases would not be that high," said Phuc.

There are causes to infant heart disease that are completely preventable, such as motherhood diabetes, fetus infections or poor pre-pregnancy diagnoses, he added.

For instance, a mother with diabetes faces three times the risk of giving birth to a child with Tetralogy of Fallot, a birth defect that affects normal blood flow through the heart, than a mother without diabetes. Babies will also face a higher risk of developing heart disease if the mothers have Rubella.

Doctors who can't detect risks of serious heart disease during pregnancy won't be able to consult parents over whether they would like to end the pregnancy, Phuc said.

Currently, the rate of infant deaths from heart disease is only 1 to 2 percent thanks to advancements in treatment and intervention. The figure shows a massive drop from ten years ago, when Professor Hoang Trong Kim, Chairman of the Ho Chi Minh City's Pediatrics Association, described the rate as being between 10 to 30 per cent.

"Vietnamese doctors can treat most of infant heart disease by far," Kim said.

Challenges remain

However, medical facilities are not the same in all localities nationwide.

Fetus x-rays are mostly done in Viet Nam's bigger cities, while there are few qualified technicians available to do the procedures in smaller provinces.

"Most of them are taken to hospital in critical condition; lacking oxygen and experiencing severe heart failure. This significantly complicates the treatment and surgical process and the result of operations."

Phuc also said that hospitals in the country lacked the necessary equipment, such as medical electric transfer vehicles, breathing machines, monitors, heart x-ray machines and recovery beds.

"We are treating our patients in poor medical conditions," he said.

Viet Nam is still facing shortages of two vital medicines widely used in many countries, PGE1 and milrinone.

"For instance, we have to ask for approval from many levels of authorities to buy PGE1, but they refused because they said this medicine is not necessary. However, if we do not have enough of these, some 3,000 infants would die," he said.

Currently, Viet Nam has 19 hospitals that can treat heart disease in children. Dozens are located in HCM City, while five are in Ha Noi. The rest are located in Thanh Hoa Province, Hue City, Da Nang City and Kien Giang Province.

Only five of these 19 hospitals can perform operations for infants. The network of child cardiologists is also limited, and concentrated in the big cities.

At the Pediatrics Hospital No. 1, each child with heart disease in need of surgery has to wait for up to a year. This is because each weak the hospital has to perform emergency surgery on 4 to 5 infants with heart diseases.

"We lack cardiology surgeons and facilities - the hospital has only one operating theatre for such operations and can only handle two a day," said Phuc from the hospital.

Minimally invasive surgical technique in heart surgery

Six patients have had their ventricular septal defects (VSDs) successfully repaired through a minimally invasive surgical technique performed by doctors at Ha Noi's E Hospital. It is the first time this new surgical method has been applied in Viet Nam.

The hospital's Cardiovascular Centre said that the patients, aged between three and 18, were showing prompt signs of recovery with no post-operative complications. They would be discharged from the hospital in five to seven days time.

According to the centre director, Associate Prof. Dr. Le Ngoc Thanh, the minimally invasive surgery (MIS) marks a new direction in the field of cardiovascular surgery. It has been used since 2000 at a number of large cardiovascular centres in the US, Germany, France and Japan in the development trend of open-heart surgery.

VSD – a congenital heart disease – is a hole in the wall (septum) between the two lower pumping chambers of the heart. Because pressure on the left side of the heart is higher than the right, in a heart with VSD, blood crosses the hole and causes the lung vessels to flood.

The MIS method can be used to close VSDs, allowing the procedure to be performed through small incisions and without stopping the heart, separating the breastbone (sternum) and ribcage, or requiring the use of a heart-lung machine.

The surgeon accesses the heart through small incisions by using specialised endovascular catheters and trans-esophageal echocardiography. This technique is less traumatic on the patient, so recovery time is faster and there are fewer post-operative complications.

VNS/VNN