Children with poor left heart development refer to poor left ventricle development. The reason for poor development is generally attributed to problems with the entrance mitral valve and outlet aortic valve of the left ventricle, which may be dysplasia or direct atresia. The left ventricle cavity becomes smaller, and the chain reaction is that the ascending aorta becomes smaller, from a large blood vessel that should have become a small blood vessel.

We know that the left ventricle is very important to the human body. The blood pumped out must support the body circulation. The left ventricle and the aorta come out small, which makes the blood flow pumped out to the body circulation smaller, making the child ischemia and hypoxia. In order to maintain the blood flow pumped out enough to maintain the body circulation, the child's heart can only speed up its operation, resulting in and aggravate heart failure. Therefore, a series of clinical symptoms mentioned above emerged.

In summary, several links in the left heart system have problems due to their mutual influence during development, so it is called left heart dysplasia syndrome.

Why does the child’s current symptoms seem to be not serious?

"He was shunted due to multiple atrial septal defects, and his arterial catheter was patented." Xie Wanying added some of her own speculation and judgment.

When the child is in the mother's belly, we talked about the situation in the chapter on the room separator. There is a difference between the heart circulation system in the fetal period and after birth. The reason for this disease is the same. You have to wait until the child breathes on his own after birth and finally you can experience the serious consequences of this heart abnormality so that the symptoms of this disease will gradually appear.

In this way, it seems that the best state to make the child not feel sick or oxygen-free is, theoretically speaking, it may be best to let the child's heart circulatory system return to the situation of the child's fetal period. The atrial septal defect is large, just like the unclosed wall during the fetal period for shunting. At the same time, the arterial catheter during the fetal period is not closed, which can allow the blood from the pulmonary artery to flow to the aorta as in the fetal period to support the systemic circulation.

As student Xie said, the child's heart has grown like this, so don't blame the symptoms.

Can this continue?

The answer is impossible. First of all, according to normal, the arterial catheter begins to close function several hours to several days after birth, and the anatomical closure is anatomically closed after one or two months, and the foramen ova is closed. Even if it is not closed, if this situation is long-term-

"It is definitely not possible to do the surgery quickly. If you delay it, you will be afraid that it will turn into pulmonary hypertension. There is no possibility of Fontan surgery when the pulmonary hypertension is not allowed." Xie Wanying said.

This requires the following principles, whether it is the pale arterial catheter or the atrial septal defect to support the shunt, the problem of insufficient blood flow in part of the systemic circulation is solved, and the existence of mixed blood cannot be prevented from being mixed in the artery. The mixed blood pumped into the systemic circulation will cause hypoxia. The Fontan operation is to perform a full-cavity pulmonary anastomosis, connecting the upper and inferior vena cava directly to the pulmonary artery. This allows only arterial blood with high oxygen content in the heart cavity to avoid mixing arterial blood. The pumped blood is only arterial blood in the systemic circulation, which can greatly improve the hypoxia of the body.

The prerequisite for Fontan surgery is that the pulmonary circulation must be good and there must be no pulmonary hypertension. What should I do? This involves the first-choice Norwood surgery, the first-choice surgery, which is the first choice for left heart dysplasia, is to simply cut the entire atrial septal defect and expand the traffic of the room.
Chapter completed!