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मेरे भाई की वर्तमान दिल की स्थिति क्या है और क्या उसे उसके ASD और माइट्रल रिगर्जिटेशन के लिए सर्जरी की जरूरत है?
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Cancer Care
Question #29618
55 days ago
152

मेरे भाई की वर्तमान दिल की स्थिति क्या है और क्या उसे उसके ASD और माइट्रल रिगर्जिटेशन के लिए सर्जरी की जरूरत है?

Client_c890f5

सवाल का पाठ: नमस्ते डॉक्टर, मुझे मेरे भाई की दिल की स्थिति को लेकर थोड़ी उलझन हो रही है और मैं आपकी सलाह चाहूंगा। उनका जन्म के समय जन्मजात हृदय रोग (Corrected TGA के साथ बड़ा VSD) का निदान हुआ था। उस समय और फिर 5 साल की उम्र में, डॉक्टरों ने कहा कि सर्जरी बहुत जोखिम भरी होगी, इसलिए नहीं की गई। अब वह 23 साल के हैं। उनकी हाल की इको रिपोर्ट में दिखाया गया है: - Corrected TGA - 1.3 सेमी Ostium Secundum ASD (लेकिन हमें बताया गया कि यह 1.3 मिमी हो सकता है – स्पष्टीकरण की आवश्यकता है) - मध्यम माइट्रल रिगर्जिटेशन - सामान्य बाइवेंट्रिकुलर फंक्शन वर्तमान में, उन्हें कोई बड़े लक्षण नहीं हैं। मेरे कुछ संदेह हैं: 1. उनकी वर्तमान स्थिति क्या है – क्या यह गंभीर है या स्थिर? 2. क्या अब सर्जरी की जरूरत है या इसे निगरानी के साथ प्रबंधित किया जा सकता है? 3. उनका दीर्घकालिक दृष्टिकोण (जीवन प्रत्याशा) क्या है? 4. क्या हमें ASD के आकार की पुष्टि के लिए इको को दोहराना चाहिए? कृपया हमें बताएं कि आगे क्या करना चाहिए और उनकी स्थिति को सही तरीके से कैसे प्रबंधित करना चाहिए। धन्यवाद।

How has your brother's overall health been since his last echo?:

- Very good, no issues

Has your brother experienced any new symptoms recently?:

- No new symptoms

What kind of monitoring has he undergone since his last surgery?:

- No follow-up since last echo

What is your brother's current level of physical activity?:

- Very active, exercises regularly

Has there been any family history of heart conditions?:

- No known family history

What did the doctor say about the need for surgery during the last visit?:

- No specific mention of surgery

Is your brother currently taking any medications for his heart condition?:

- No medications
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Doctors' responses

Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
55 days ago
5

Hello dear See as per clinical history it seems presence of Mr valve dysfunction Presence of congenital heart problem Asd or atrial septal defects So you need to undergo follow up with following tests Echo repeat Ct scan/ MRI Serum troponin Serum cck Mb Serum LDH In addition please get in person consultation with cardiologist for following options Asd device replacement Valve replacement Regards

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The current situation for your brother involves a complex congenital heart condition, known as corrected transposition of the great arteries (TGA), coupled with an atrial septal defect (ASD) and moderate mitral regurgitation. Based on the information provided, his heart is functioning adequately without major sypmtoms, which is a positive indicator. However, clarifying the exact size of the ASD is essential, as the difference between 1.3 cm and 1.3 mm is significant. A 1.3 cm hole could imply a larger functional defect, potentially warranting intervention, while 1.3 mm might indicate greater stability.

Currently, his condition seems to be stable, with normal biventricular function suggesting that both heart chambers are pumping effectively. This often reduces the urgency for surgical intervention if he remains asymptomatic. However, moderate mitral regurgitation means some blood is leaking backward through the mitral valve, which is common with heart defects like TGA and can worsen over time.

To address your questions, monitoring is key here. Regular follow-ups with a cardiologist specializing in congenital heart disease is essential. A repeat echocardiogram to confirm the ASD size is advisable to ensure accurate assessment and management. The decision about surgery typically depends on symptoms, progression regarding heart function, pressures within heart and any residual effects.

Longevity can be challenging to predict without knowing specific individual circumstances, but modern advances in managing congenital heart disease have improved long-term outcomes considerably, often allowing a near-normal life expectancy. The need for intervention is complex and should be personalized: regular evaluations will help decide when, or if, surgical intervention is necessary. Keep in close communication with your healthcare provider to effectively manage his condition and prevent any potential complications.

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