He was surprised to feel little pain after surgery at the National Heart Centre Singapore
After a two-and-half hour open-heart surgery in 2009 to mend a hole in his heart, Mr. Satha Sin was surprised to wake up with just body aches. In Cambodia where he came from, an open-heart surgery is shrouded in fear and many horror stories of unbearable post-operation pain. According to Mr. Satha Sin, Cambodians even think that one can become disabled after an open-heart surgery. He was relieved to find, in his case, that those fears were quite unfounded.
Mr. Satha Sin works as a public relations officer with a non-governmental organisation in Cambodia. He suffered from Atrial Septal Defect (ASD), commonly called a hole in the heart. Mr. Satha Sin discovered his condition in 2008 after consulting a doctor in Cambodia. The doctor performed an echocardiogram on him, which is a test that uses ultrasound to detect any abnormalities of the heart.
Atrial Septal Defect is an opening in the septum that separates the heart’s two upper chambers. The septum is a wall that separates the heart’s left and right sides. Everyone is born with an opening between the upper heart chambers. This opening closes or becomes very small within weeks or months after birth. In some cases, the opening does not close after birth, leading to ASD. If left untreated, a patient with severe ASD can develop heart failure later in life.
Mr. Satha Sin decided to treat his ASD at the National Heart Centre Singapore, after reading up about a number of hospitals in Asia. He said, “After my first visit to the National Heart Centre Singapore, I felt that if I cannot trust this heart centre, I would not be able to trust any other hospital. That’s why I decided to come to Singapore for my treatment.” He was also impressed by the prompt response from the NHCS. He said, “My wife wrote an email to the heart centre and she got a reply in 15 minutes. Subsequent emails with the NHCS were equally prompt.”
At the NHCS, Dr. Paul Chiam, a consultant with the department of cardiology, conducted a couple of diagnostic tests before the surgery was performed. One was an ECG or an electrocardiogram, a test that records the electrical activity of the heart. The other was a Transesophageal Echocardiogram (TEE), which is a test used to determine the presence of various types of heart diseases such as valve disease. Once the diagnosis was confirmed, Dr. Chiam referred the patient to Dr. Lim Yeong Phang, a consultant at the department of cardiothoracic surgery in NHCS, who performed the operation. Dr. Lim explained, “Mr. Sin's ASD was extremely large. To mend the hole in his heart, it was necessary to use a patch from the patient’s pericardium to close it up.” The pericardium is the thin sac (membrane) that surrounds the heart and the roots of the major blood vessels.
Soon, Mr. Satha Sin is ready for his open-heart surgery. “After my surgery, I called my family in Cambodia, they were so surprised I could speak so soon”, laughs Mr. Satha Sin.
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What is Atrial Septial Defect (ASD)?
Atrial Septal Defect (ASD) is an opening in the septum between the heart’s two upper chambers (atria). The septum is a wall that separates the heart’s left and right sides. This condition is sometimes called a “hole” in the heart. Everyone is born with an opening between the upper heart chambers. After birth, the opening usually closes or becomes very small within weeks or months. However, in some people, the opening is larger than normal or doesn’t close after birth. This is a natural process and no medicine can close up the opening.
The cause of ASD is not known but it is thought that genetic factors play a role. Some patients with ASD have no symptoms, especially if the opening is small. If the opening is large, it may cause mild shortness of breath, especially with exertion. Patients with small ASD may not need surgery or other treatments. In the case of a large Atrial Septal Defect, an open-heart surgery may be necessary. It is crucial to diagnose ASD early in life as ASD can affect the heart’s ability to pump blood throughout the body and may eventually lead to a heart failure.
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What is an open-heart surgery?
Open-heart surgery involves operating on structures inside or on the surface of the heart. The surgery consists of exposing the heart through an incision in the sternum (chest bone). The patient is connected to a heart-lung machine, which acts as an artificial heart and lung so that the surgeon is able to stop the heart and operate in a relatively bloodless condition.
A newer type of surgery is minimally invasive heart surgery, or keyhole surgery. Minimally invasive surgery involves operating on the same structures in the heart via other approaches, by avoiding cutting the sternum or doing a partial cut on the sternum. It uses smaller incisions than traditional heart surgery; the heart surgeon may also use a robotic arm to perform part of the surgery. While keyhole surgery reduces the trauma and recovery time for patients, it is currently not used to treat all heart conditions. Heart doctors will normally evaluate the benefits and risks of each type of surgery to recommend the best surgical option for patients. |
For more information about ASD and other heart conditions, log on to www.nhcs.com.sg