Pediatric Cardiology and cardiac surgery

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Millions of patients worldwide have chosen treatment at the renowned Hadassah Clinic in Israel. Known for its cutting-edge medical expertise and compassionate care, Hadassah has become a beacon of hope for individuals seeking top-tier healthcare. With a legacy of healing and innovation, it continues to make a difference in countless lives.

Since 2011, the department has been providing medical services at the level of leading cardiology centers in the United States. Some of the procedures performed here are available in only a few clinics worldwide, while many others can only be carried out at the Hadassah Clinic in Israel.

Since 2009, Hadassah has been the only Israeli hospital to integrate the database of its cardiology and cardiothoracic surgery departments into the National Database of the American Society of Thoracic Surgeons (STS).

To receive a consultation from one of the leading specialists or to learn more about the possibilities of pediatric cardiology and cardiac surgery at the Hadassah Clinic please contact our staff.

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Advantages of Treatment at Hadassah Hospital

Unlike many other medical centers in the West and the Middle East, Hadassah Clinic treats congenital heart defects (CHDs) from a very early age. They perform intrauterine treatment of CHDs in unborn children, carry out corrections of CHDs in premature infants, and close atrial septal defects in children weighing more than 1.4 kilograms (1,400 grams). This comprehensive approach to congenital heart defect treatment highlights their dedication to providing care at all stages of life, from before birth to infancy.

According to pediatric cardiologists and cardiothoracic surgeons, one of the main advantages of treatment at the Hadassah Clinic is the high efficiency: a maximum of 1 week is sufficient for diagnosis and decision-making, and within a maximum of 2 weeks, the child undergoes surgery or another invasive procedure.

The leading specialists of the Department

Professor Alain Serraf Head of the Pediatric Cardiology and Cardiac Surgery Department at the Hadassah University Hospital.

Specialization: congenital heart defects.

37 years of experience

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Doctor Julius Golender Senior expert of the Pediatric Cardiology and Cardiac Surgery Department at the Hadassah University Hospital.

Specialization: coronary angiography, congenital heart defects in children, preparation for all types of heart surgery, postoperative monitoring.

16 years of experience

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Doctor Zeev Perles Senior expert of the Pediatric Cardiology and Cardiac Surgery Department at the Hadassah University Hospital.

Specialization: intrauterine heart surgery, echocardiography in embryos and newborns.

27 years of experience

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Diagnosis of Congenital Heart Defects in Children in Israel

Congenital heart defects can be completely cured if they are diagnosed in a timely manner.

This condition can manifest in a child’s unusual behavior and developmental abnormalities. In infants, you may notice:

  • Increased fatigue
  • Difficulty breathing
  • Swelling
  • Sweating
  • Reduced urination
  • Unhealthy skin color
  • Fainting

Of course, when parents observe such symptoms, they promptly seek medical attention, and congenital heart defects are often diagnosed in the first few months of a child’s life or at birth during routine examinations. Small defects may sometimes only be detected by unusual heart murmurs during regular check-ups with a pediatrician.

Occasionally (rarely), heart defects may present for the first time in adolescence or adulthood.

To assess the condition of the heart muscle, heart valves, and circulation defects, doctors use ultrasound examinations, known as echocardiography. If necessary, a heart X-ray with the injection of contrast agents, called ventriculography, may be performed. Catheterization of the heart is also used to measure pressures within the heart chambers.

The methods of treatment

To enhance the effectiveness of treatment, specialists at Hadassah Medical Center tailor the treatment method individually for each specific case. Critical factors include:

  • The child’s age, overall health, and medical history.
  • The stage of PDA in the heart.
  • The patient’s response to specific medications.
  • Tolerance for certain procedures and treatment methods.

Fetal Heart Catheterization

Diagnostic or therapeutic intrauterine catheterization of the heart (fetal heart catheterization), which is excellently performed in the department, can only be carried out in very few medical centers worldwide, and in Israel, such specialists are not found anywhere else. At Hadassah Clinic, the procedure is performed with the involvement of an experienced gynecologist.

High-Risk Surgeries for Newborns

The department successfully performs high-risk surgeries that are rarely undertaken even by the largest cardiac centers in the former CIS countries. Among them is the correction of congenital defects in premature infants. Doctors at the Hadassah Medical Center perform heart surgeries on newborns weighing as little as 1.4 kilograms, and vascular surgeries are performed on newborns of any weight.

In 2019, at the Hadassah Clinic, an emergency non-surgical heart catheterization was performed on a girl weighing 860 grams with the aim of treating a congenital atrial septal defect (ASD).

Treatment of a congenital ventricular septal defect (VSD)

Normal heart function is based on the fact that venous blood from the body, entering the right atrium and ventricle, first goes to the lungs, where it becomes oxygenated. Only after completing the pulmonary circulation loop does it enter the left side of the heart, from where it is pumped out through the aorta to circulate throughout the body, completing the systemic circulation loop. Importantly, venous blood from the right side of the heart does not mix with oxygenated blood from the left side.

Various defects in the septum, which separates the chambers of the heart, can disrupt this separation of venous and arterial blood. Such congenital defects can occur between the atria (atrial septal defects) or between the ventricles (ventricular septal defects).

According to statistics, 97% of children with VSD (Ventricular Septal Defect) who undergo surgery at Hadassah Clinic fully recover and go on to lead normal lives.

At the clinic, VSD is treated using the most advanced techniques, such as the closure of the defect with self-expanding AMPLATZER occluders made of a titanium and nickel alloy of the latest generation. The occluder is inserted through non-surgical catheterization, performed by a renowned specialist in interventional cardiology, the well-known pediatric cardiac surgeon with over 35 years of experience, Professor Alain Serraf.

Therapeutic Cardiac Catheterization

Cardiac catheterization is a minimally invasive procedure that involves inserting a catheter through the femoral artery to reach the site of the heart defect. Through this catheter, a mesh patch is delivered, which closes the opening in the ventricular septum. Over time, the patch becomes covered with connective tissue fibers, completely closing the defect. Catheterization is performed under X-ray guidance. The most modern form of this operation involves the placement of the self-expanding AMPLATZER occluder mentioned earlier.

The clinic performs more than 2,400 successful diagnostic and therapeutic heart catheterizations annually. The rich experience of the physicians ensures the safety and effectiveness of the procedure.

An individually selected occluder, matched to the size of the defect being corrected, is placed in a delivery system and inserted into the heart chamber. Using video equipment, the physician ensures the precise placement of the occluder. Afterward, the delivery device is detached from the “patch.”

The vascular catheter and the esophageal echocardiography probe are removed, and the procedure is considered complete. The entire procedure takes approximately one hour. The length of postoperative hospitalization can range from one to several days and is determined on an individual basis.

Radical Surgery

The classic surgery for “sewing up” the defect or placing a special patch (which eventually fully integrates into normal heart tissue) is performed using a heart-lung machine. Synthetic materials or the patient’s own pericardial tissue, from which a small flap is cut, are used for patching the opening. After the defect is closed, blood circulation normalizes, but regular monitoring by a cardiologist remains necessary.

Palliative Surgery

For children who, for some reason, are not immediately suitable candidates for surgical correction of the defect, there is an option for an intermediate operation that alleviates the most severe symptoms and gives the child a chance for normal development. This is a partial treatment measure for VSD, significantly narrowing the lumen of the pulmonary artery. During such an operation, the pulmonary artery lumen is artificially narrowed, reducing blood flow in the lungs and lowering pressure in them to normal levels.

It is important to consider that, in addition to the appearance of respiratory symptoms, a ventricular septal defect is “aggressive” in terms of the development of so-called pulmonary hypertension. This manifests as a significant increase in pressure in the pulmonary blood vessels. Such a serious complication is a contraindication to surgery, which is crucial for patients with large defects. Therefore, timely detection of the pathology and referral of the patient for surgery is of utmost importance.

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Treatment of atrial septal defect (ASD)

Unlike a ventricular septal defect, the defect in the septum between the atria never closes on its own. Therefore, it is one of the most common congenital defects diagnosed in children older than three years. Atrial septal defect occurs with a frequency of 3-20% of all cases of congenital heart defects. The defect can be very small, or it can involve the complete absence of a septum between the left and right atria.

In the case of a significantly pronounced defect, blood from the left atrium (oxygen-rich) returns to the right atrium and passes through the lungs again—although it cannot receive additional oxygen from them—thereby reducing the effectiveness of circulation and creating an unnecessary burden on the heart and lungs.

The operation to close the atrial septal defect is the only method of treating this condition. Typically, it is planned for children aged 3 to 6 years, without delaying it until potential complications develop. The more experienced the cardiac surgeon, the more successful the surgical intervention is likely to be. In the Center for Pediatric Cardiology and Cardiac Surgery, the treatment of atrial septal defects in children is performed by Prof. Alain Serraf, who has a record of numerous successful ASD surgeries in children.

In the clinic, correction of ASD (Atrial Septal Defect) is performed using state-of-the-art self-expanding occluders known as AMPLATZER devices. These occluders are introduced using thin catheters, making it a minimally invasive, non-surgical procedure.

Treatment of patent ductus arteriosus (PDA)

In a fetus, the arterial duct connects the pulmonary artery and the aorta. When a child is born, the lungs expand, and the oxygen content in the blood increases, which stimulates the narrowing and eventually the complete closure of the arterial duct within the first few days of life. Through the pulmonary artery, venous blood from the right ventricle passes from the heart to the lungs, where it becomes oxygenated. Meanwhile, through the aorta, oxygen-enriched blood from the left ventricle exits the heart and is distributed through arteries and capillaries to all organs and tissues. Thus, the closure of the arterial duct is necessary to prevent the mixing of venous and arterial blood. However, sometimes, especially in premature infants, the arterial duct does not close on its own, and a portion of oxygen-rich blood from the aorta returns to the pulmonary artery.

The primary method of treating PDA (Patent Ductus Arteriosus) at Hadassah is the closure of the duct using specialized self-expanding occluders – microscopic devices in the form of a plug or coil (the type of occluder depends on the size of the opening). These occluders are made from modern materials that do not react chemically with blood, and they are delivered to the necessary location using a thin catheter (therapeutic cardiac catheterization).

At Hadassah Clinic, the most advanced self-expanding occluder in use today is the AMPLATZER.

Treatment of tetralogy of Fallot

The only method for the definitive correction of Tetralogy of Fallot is surgical intervention. During episodes of cyanosis, especially with loss of consciousness, oxygen therapy and morphine are administered. Medications like propranolol may also be used to prevent new episodes. However, the ultimate correction can only be achieved through the complete correction of defects or the creation of a temporary artificial connection between the aorta and pulmonary artery.

This surgery can be performed urgently if the child’s life is in danger, but it can also be planned. In the latter case, the timing of the correction is determined individually, taking into account all the characteristics of the young patient. There are cases where the correction of this defect was even performed in utero—through an incision in the uterine wall. Sometimes, the correction may be delayed until a later age than early childhood, but the prognosis is better the earlier the defect is corrected.

What is a congenital heart defect?

A congenital heart defect is the most common anomaly of the cardiovascular system. With this condition, normal blood flow through the vessels or within the heart muscle is not possible.

The main types of congenital heart defects in children include:

  • Ventricular Septal Defect (VSD): This is a hole between the two ventricles of the heart, allowing blood to flow between them.
  • Atrial Septal Defect (ASD): This is a hole between the two atria of the heart, also allowing blood to flow between them.
  • Patent Ductus Arteriosus (PDA): This is a condition in which the arterial duct, which typically closes after birth, remains open, allowing blood to bypass the lungs.
  • Tetralogy of Fallot: This is a complex condition involving four main heart defects, including a ventricular septal defect, pulmonary artery stenosis, displacement of the aorta, and an enlarged right ventricle.
  • Transposition of the Great Arteries (TGA): This condition involves the arteries and veins exiting the heart in incorrect anatomical positions, disrupting normal blood flow.

Congenital heart defects require medical intervention and care, and treatment can vary from medication to surgical procedures, depending on the type and severity of the defect.

How to Come for Treatment in Israel?

To receive assistance in scheduling a remote consultation with a leading Israeli specialist, handling the necessary documents for your visit to Israel, booking flights and accommodation, as well as addressing other organizational matters, please call the phone numbers provided on the website or fill out the contact form. Experienced staff will promptly respond and provide you with all possible assistance.

Upon arrival in Israel, each patient is assigned a personal coordinator who oversees the implementation of the previously established treatment plan, assists with practical matters, and accompanies the patient to meetings with doctors and procedures.

Cost of Treatment in Israel

The cost of treatment at Hadassah Hospital in Israel is regulated by the Ministry of Health, so the prices here do not exceed the national average. Moreover, they are lower than those in European and American institutions of a similar level. The main factor that determines the price of the course is the stage at which the disease is detected and the chosen treatment strategy. It is worth noting that Israeli doctors consider the results of tests conducted in the patient’s home country, which can reduce the cost of treatment.

Procedure name Price in USD $
Consultation of Pediatric Cardiologist start at $734
Consultation of world–renowned Professor start at $840/991

To receive a consultation from one of the leading specialists or to learn more about the possibilities of pediatric cardiology and cardiac surgery at the Hadassah Clinic please contact our staff.




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