Congenital Heart Disease: When a Child's Heart Needs Surgery

Congenital heart disease (CHD) is the most common birth defect, affecting approximately 1 in 100 babies born worldwide. It refers to structural abnormalities of the heart that are present at birth — holes in the heart, narrowed valves, abnormal connections between heart chambers, or complex malformations involving multiple structures.

Many CHD cases are diagnosed during pregnancy (foetal echocardiography) or shortly after birth. Some defects are minor and close on their own; others require surgery in the first days, weeks, or months of life. Without treatment, complex CHD can be fatal.

• Ventricular septal defect (VSD) — a hole in the wall between the two lower chambers; the most common CHD
• Atrial septal defect (ASD) — a hole in the wall between the two upper chambers
• Patent ductus arteriosus (PDA) — a blood vessel that should close after birth remains open
• Tetralogy of Fallot (TOF) — a combination of four heart defects causing blue baby syndrome (cyanosis)
• Transposition of the great arteries (TGA) — the aorta and pulmonary artery are switched; requires surgery within the first week of life
• Pulmonary stenosis — narrowing of the pulmonary valve
• Coarctation of the aorta — narrowing of the main artery leaving the heart
• Hypoplastic left heart syndrome (HLHS) — the left side of the heart is severely underdeveloped

Signs That a Child May Have a Heart Problem

Some congenital heart defects are detected before birth or immediately after. Others may not cause obvious symptoms until weeks, months, or even years later. Parents should be aware of the warning signs.

• Bluish tinge to the lips, tongue, or fingertips (cyanosis) — indicates low oxygen in the blood
• Rapid breathing or difficulty breathing, especially during feeding
• Poor feeding — the baby tires quickly during feeds and does not gain weight
• Failure to thrive — poor weight gain and growth despite adequate feeding
• Excessive sweating during feeding or crying
• Swelling of the legs, abdomen, or around the eyes
• Frequent respiratory infections (pneumonia, bronchitis)
• Heart murmur detected by a doctor during examination
• Fainting or loss of consciousness during exercise (in older children)
• Chest pain or palpitations during physical activity

Paediatric Heart Surgery in India

India has some of the world's finest paediatric cardiac surgery programmes. Fortis Escorts Heart Institute (Dr. Neeraj Awasthy), Medanta, Apollo, and Max hospitals perform hundreds of complex paediatric heart surgeries every year — including neonatal surgery in the first days of life.

India's paediatric cardiac surgery outcomes are comparable to the best centres in the USA and UK, at a fraction of the cost. Many families from Africa, Central Asia, and the Middle East bring their children to India because the cost of the same surgery in their home country or in Western countries is unaffordable.

• Open-heart surgery for VSD, ASD, TOF, and other complex defects — using cardiopulmonary bypass (heart-lung machine)
• Arterial switch operation for transposition of the great arteries — must be performed within the first 2 weeks of life
• Norwood procedure for hypoplastic left heart syndrome — a staged surgical approach
• Catheter-based interventions — ASD and VSD closure using devices (no open-heart surgery); PDA ligation
• Balloon valvuloplasty — opening a narrowed valve using a balloon catheter
• Fontan procedure — for children with a single ventricle; staged surgery over the first 3–4 years of life
• Neonatal cardiac surgery — surgery in babies less than 30 days old; available at top Indian centres

What Families Should Know About Recovery

Recovery after paediatric heart surgery depends on the complexity of the defect and the type of surgery. Children are remarkably resilient — most recover faster than adults. After successful surgery, most children with CHD go on to live normal, active lives.

Families travelling from overseas should plan to stay in India for 3–6 weeks after surgery for close monitoring before the child is cleared to fly home.

• ICU stay: 2–5 days after open-heart surgery; longer for complex neonatal surgery
• Hospital stay: 7–14 days total for most procedures
• Overseas families: plan to stay in India for 3–6 weeks after surgery
• Feeding: most children resume normal feeding within days of surgery
• Activity: children can return to normal play within 4–6 weeks; contact sports after 3 months
• Follow-up: echocardiogram at 1 month, 6 months, and annually
• Long-term outlook: most children with corrected CHD live normal lives; some may need further procedures as they grow
• Emotional support: Wiseheal Healthcare provides a dedicated coordinator for paediatric cases — supporting the family throughout the journey