Our heart has four chambers; namely, two auricles and two ventricles. Through the pulmonary artery, the blood without oxygen is sent to the lungs for oxygen supply and return to the heart via pulmonary veins for distribution in the body. In some cases, especially in children just born, an unusual fault is observed where the pulmonary veins get linked to other sites in the heart instead of the accurate position of the upper right heart chamber, also known as the right atrium and mixes with the oxygen-deficient blood in there or before entering the heart. According to the location and direction of the destination, four different TAPVC is found and are named as cardiac, supra-cardiac, and infra-cardiac TAPVC.
This defect is congenital. The blood supply may continue through an Atrial Septal Defect, also present in the child just born. The Atrial septal defect constitutes a different surgery. Usually, the team of surgeons working on the TAPVC repair also corrects the Atrial Septal Defect along with the main operation.
The operation for handling this error where the cardiac surgeon joins the pulmonary veins to the left atria and closes an aperture between the two atria is known as Total anomalous pulmonary venous connection (or return) surgery or TAPVC surgery.
The cutting-edge medical and healthcare knowledge has made Israel one of the sought-after endpoints for patients to come from all over the globe. With the advanced medical setup, the country is considered as one of the few destinations where the complex TAPVC surgeries can be performed without any further problems. The progression of multi-specialty hospitals, specifically in the field of cardiac sciences has further heightened Israel’s status as the go-to country for better and professional quality medical care.
The country has many cardiac surgeons that are gifted in the field of minimally invasive and open-heart surgeries for the correction of this particular cardiac defect. Hospitals like the Kaplan Medical Center (Rehovot), Rabin Medical Center (Petah Tikva), and Sourasky Medical Center (Tel-Aviv) have devoted cardiology departments where surgical procedures that are related to the heart are carried out. These and many other reasons make Israel an important country for getting a TAPVC surgery.
In the UAE it costs on average approximately $21251 for TAPVC techniques in the states of the Arab Emirates. But in Israel, you get the same international quality healthcare and successful procedures done for around 60% to 65% less of the treatment cost of the UAE and other developed countries.
Total Anomalous Pulmonary Venous Connection (TAPVC) or Total Anomalous Pulmonary Venous Return (TAPVR) is a rare congenital disorder characterized by a malformation in all the four pulmonary veins that carry oxygenated blood from the lungs to the atrium. The malformation is such that the veins do not connect to the left atrium perfectly.
In case of TAPVC, the four pulmonary veins drain into the right atrium because of an anomalous connection. There are different TAPVC types, depending on where and how the pulmonary veins drain into the right atrium. The common TAPVC types include supracariac, cardiac, and infracardiac TAPVC.
All types of TAPVC are corrected with the help of a surgery, which is conducted during infancy itself. Additionally, all types of TAPVC almost always have an atrial septal defect (ASD), which requires a separated surgery for its closure. An ASD is a hole between the upper two chambers of the heart. As a result, some amount of oxygenated blood from the right atrium is transferred to the left atrium and out from the body.
TAPVC is detected as soon as the baby is born or even before. The following are some of the main TAPVC symptoms:
TAPVC repair is conducted as soon as the condition is diagnosed, which may happen during pregnancy or after the birth of the baby. However, the exact time as to when the repair is conducted depends on the overall health of the baby. During TAPVC repair, the neonatal cardiac surgeons connect the pulmonary veins to the back of the left atrium to restore the normal flow of blood to the heart. Additionally, they also close off any abnormal connection between the pulmonary veins. The TAPVC repair procedure does not end there. The last step in the repair mostly includes the closure of the ASD. Prior to the surgery, the body of the child is connected to an artificial heart-lung machine. The machine is disconnected as soon as the normal beating of the heart is restored after making doing all the corrective repairs.
TAPVC repair success rate is excellent with over 95 percent success rate in children who are treated electively. A child or an adult may undergo TAPVR surgery successfully, however, that does not mean that it is fully cured. They will have to attend follow-up appointments with the surgeon in the future on a regular basis. The success rate, on the other hand, is low when the procedure is conducted on an emergency basis in critically-ill infants. Even if infants do survive after undergoing emergency TAPVC repair procedure, they will be kept under a prolonged post-surgery intensive care. They are also put on a ventilator machine to assist breathing.
Even is the repair is successfully handled, the patient is required to attend follow-up session with the surgeon for the rest of your life. During the follow-up appointments, the surgeon will check the progress and keep a tap on health conditions that may develop as the child grows into an adult. Most of the children who undergo TAPVC repair and ASD closure are able to grow and develop normally. Abnormal cardiac rhythm and obstruction in the pulmonary veins are the two post-surgical complications that may rarely occur.
TAPVC is considered a high-risk procedure, as it requires immense expertise and finesse to operate on a newborn child. It is critical that the infant patient gets to contact the best heart specialists and cardiac physicians to get suitable neonatal medical care. The state of the quality of health services in Israel has made the country the most favorite choice for TAPVC surgeries of infants and new-born children with these specific cardiac issues.
As the patient receiving this surgery is usually a new-born baby, who has virtually no possible strength to bear the stress of this surgery, the safety of TAPVC surgery constitutes a serious issue. However, with the best medical expertise of the proficient cardiologist and cardiac surgeons present in the different hospitals in this country, the surgeries conducted are deemed extremely safe. The success rate for TAPVC as an elective surgery for patients has a high success rate of 95%.
The presence of hospitals with dedicated cardiac departments and proficient medical team have made the country of Israel a most sought-after destination for cardiovascular surgeries. In a single hospital, around 5000 successful thoracic and cardiac surgeries are conducted each year.
Some of the principal factors in the total cost include;
The charge of the operation theater
The fees of the pediatric cardiac surgeon and any other consultant.
The life-support machines (heart-lung machine, ventilator).
The cost of the drugs given.
Flight, transfers, accommodation
Hospital stay for around 2-3 weeks
The type of surgery (either minimally invasive surgery or open-heart surgery)
The patient party visiting Israel for a TAPVC surgery shall be able to complete their purpose at a fraction of the cost of having the same at USA or UK.
There are several international quality hospitals for cardiothoracic surgery in Israel; among them, Kaplan Medical Center (Rehovot), Rabin Medical Center (Petah Tikva), and Sourasky Medical Center (Tel-Aviv) are more or less heard of.
Among the several cardiac surgeons accessible, Dr. Ben-Gal Yanai, Doctor Ram Sharoni, Dr. Carlos Gruzman is known to be the person to look out for in case of pediatric cardiac surgery.
Not only the doctors, the hospitals in Israel follow a strict protocol while selecting medical staffs, which is why, the quality of even the support staffs remain incomparable. The support staffs are also trained to handle emergency situations as well as critical cases with umpteenth care so as to ensure complete healthcare to the candidate undergoing minor to major procedures.
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