Annex A > Chapter 3 - Developments in the UK, in the Diagnosis and Treatment of Congenital Heart Abnormalities in Children, 1984-1995 > The specific heart abnormalities and procedures referred to in the Inquiry

The specific heart abnormalities and procedures referred to in the Inquiry

Introductory comments

36 The heart abnormalities discussed in the following text include most of those that have been of special interest to the Inquiry. They help to illustrate trends in the development of cardiac services and approaches to management of children with abnormal hearts. Each abnormality is discussed in relation to the structural problem, its effect on the function of the heart and the overall effect on the patient. Methods of diagnosis and their development are also described. The surgical approach and any changes over the period 1984 to 1995 are touched on briefly. Important trends are identified in relation to some of the abnormalities and surgical procedures. The text does not address in any detail the mortality rates, the longer-term effects of some of the operations, or other risks. Comprehensive information on mortality rates in the UK between 1984 and 1995, including an evaluation of the strengths and weaknesses of the data sources on which they are based, can be found in a paper by Dr David Spiegelhalter et al, commissioned for this Inquiry. [9]

37 In general terms, post-operative complications may occur after any operation but are more likely after the more complex procedures. Complications may involve the heart itself or may affect other organs. The more common serious cardiac complications include heart failure; damage to the blood vessels that actually supply the heart muscle with blood (the coronary arteries); disturbance of the heart rhythm such as `heart block' when the heart beats very slowly or alternatively when it has episodes of beating very fast or irregularly. Organs that may be seriously affected include the brain, kidneys, liver and gut. Some of the complications which affect other organs may be more serious than complications affecting the heart itself.

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Footnotes

[9] Spiegelhalter D, et al. `Overview of Statistical Evidence Presented to the Bristol Royal Infirmary Inquiry Concerning the Nature and Outcomes of Paediatric Cardiac Surgical Services at Bristol Relative to other Specialist Centres from 1984 to 1995'. See Annex B