Prof. Dr. Ali Serdar Fak
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Congenital Heart Disease
Congenital heart surgery
What congenital heart surgery is, which defects are repaired and how, how surgery differs from catheter treatment, what the evidence says about outcomes, who needs it and when, approximate costs in Turkey against the UK, US and Germany, hospital stay and recovery stages, risks, and how families can judge a paediatric or adult congenital heart team.
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Dr. Bülent İlçöl
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Congenital heart surgery in Turkey: what it is and when it is needed
Congenital heart surgery repairs or reshapes a heart or large blood vessel that formed differently before birth. Defects range from small holes between chambers that may close without treatment, to complex conditions in which the heart has a single working pumping chamber or the main vessels are connected the wrong way round. Surgery is done in newborns, children and, increasingly, adults whose defect was missed, partly repaired in childhood or has caused later problems such as a leaking valve or a narrowing. This guide explains the main operations, how they differ from catheter treatment, what outcomes look like, what the cost range is in Turkey compared with the UK, US and Germany and how to judge a specialist team.
A congenital heart defect is a medical condition that needs a specialist diagnosis; this page does not replace one. If you or your child have already been assessed, the questions below help you prepare for a second opinion. For related heart care see our overview of cardiology and cardiac treatments in Turkey. Vein procedures such as sclerotherapy of varicose veins belong to a different field and are not part of congenital heart care.
Which congenital heart defects are repaired by surgery?
The most common operations treat:
- Atrial and ventricular septal defects (ASD, VSD): a hole is closed with stitches or a patch.
- Patent ductus arteriosus (PDA): a vessel that should close after birth is tied or divided, though many are closed by catheter.
- Tetralogy of Fallot: the hole is closed and the narrowed outflow to the lungs widened.
- Coarctation of the aorta: the narrowed section is removed, widened or bypassed.
- Transposition of the great arteries: the arterial switch operation moves the vessels to their correct heart chamber.
- Single-ventricle conditions: a series of staged operations (such as the Glenn and Fontan procedures) directs blood to the lungs.
- Valve defects: repair or replacement; in adults with a bicuspid aortic valve see replacement of the aortic valve.
Some defects need one operation; others need two or three at different ages, and many need lifelong follow-up.
How does congenital heart surgery work?
Most repairs are open-heart operations under general anaesthesia. The surgeon opens the chest through the breastbone or, in suitable cases, a smaller incision between the ribs. While the heart is repaired, a heart-lung machine (cardiopulmonary bypass) takes over the work of the heart and lungs, and the heart is briefly stopped. The surgeon closes holes with a patch, widens or replaces narrowed vessels and valves, or redirects blood flow. Operations last from about two to six hours and longer in complex cases. After surgery the patient goes to an intensive care unit for monitoring, drains and medicines that support the heart. In newborns the timing is decided by how unwell the baby is, and some operations are urgent.
Surgery, catheter treatment or watching and waiting: how do they compare?
| Approach | Best suited to | Typical limits |
|---|---|---|
| Open surgical repair | Large or complex defects; several problems at once | Needs bypass and intensive care; longer recovery and a scar |
| Catheter (transcatheter) closure or valve procedure | Suitable ASD, PDA, some valve and vessel narrowings | Depends on anatomy and device size; not possible for many complex defects |
| Observation and medication | Small defects, mild valve problems, borderline cases | Does not correct the defect; needs regular imaging and clinic visits |
Which approach is right depends on the defect, the age and weight of the patient and the findings on echocardiography and other tests. A hybrid team of surgeon and interventional cardiologist will often discuss the options together.
How well does congenital heart surgery work, and what do the studies say?
Outcomes have improved greatly over the past decades, and most children with defects such as ASD, VSD or PDA now live into adulthood after repair. Registry data from North America and Europe show that survival after surgery for simple defects is very high and that survival for complex defects depends on the type, the condition of the child at surgery and the experience of the team. The evidence is less certain for long-term results of complex repairs: many patients need further procedures, rhythm treatment or valve surgery later in life. Surgeons who treat congenital heart disease are advised by professional societies to keep annual case numbers high; a good team publishes or shares its own results. No honest team will promise a particular outcome.
Congenital heart surgery cost in Turkey compared with the UK, US and Germany
The figures below are wide approximate ranges for an operation with the hospital stay, not hospital quotes. Complex and staged operations, long intensive care stays or complications can cost far more.
| Country | Approximate cost range |
|---|---|
| Turkey | €8,000 – €35,000 |
| United Kingdom (private) | €20,000 – €70,000 |
| United States | €60,000 – €200,000 |
| Germany | €25,000 – €75,000 |
What changes the price: the defect and the number of operations, the age and weight of the patient, the days in intensive care and on the ward, the implants or valves used, tests such as MRI and catheter studies and the care of a parent or companion. A written package should list what is included and what is billed separately, such as extra intensive care days, blood products or treatment of complications. Ask what the hospital does when the stay is longer than planned.
Who is a candidate, and when is the timing right?
The decision is made by a paediatric or adult congenital cardiologist and surgeon on imaging and symptoms, not on a general rule. Surgery is generally offered when a defect causes symptoms, strains the heart, risks harming the lungs or when waiting would make repair harder. Some babies need surgery in the first weeks; others are operated on at several months or a few years; small defects may only need observation. Adults with repaired or unrepaired defects can need surgery for a leaking valve, a narrowed vessel or an enlarging aorta. A patient who is very unwell with infection or lung disease may need treatment first, and some people with advanced pulmonary hypertension are not suitable for repair. A second opinion based on the original reports and images is reasonable before any decision.
What tests come before surgery, and how should families prepare for travel?
A congenital team will want echocardiograms, an ECG, chest X-ray and often cardiac MRI or CT; some need a diagnostic catheter study. Send the original reports and image files in advance so that the team can give an opinion before you travel. Travelling with a child before or after heart surgery needs clearance from the cardiologist, a plan for oxygen if the child is blue, and medical records in English. Ask whether the hospital has a dedicated paediatric cardiac intensive care unit, paediatric anaesthetists and interpreters. Most families stay three to six weeks in total for a standard repair: about a week in hospital, followed by time nearby for check-ups before the flight home.
Hospital stay and recovery after congenital heart surgery
For a straightforward repair the stay in intensive care is often one to three days and the total hospital stay is about five to ten days; complex or newborn operations can need weeks. Breathing tubes and drains are removed in the first days, and walking or feeding restarts gradually. At home the chest wound heals over four to six weeks; children usually return to school after four to eight weeks and avoid contact sports and heavy lifting for around three months. Adults often take six to twelve weeks off work. Medicines, such as anticoagulants or heart-rhythm drugs, may continue. Regular cardiology review with echocardiography is part of lifelong care, and the hospital should send a clear discharge summary.
What results can families realistically expect?
After a successful repair many children grow, feed and play more normally, turn less blue or breathless and need fewer medicines. Scars are usually a vertical line over the breastbone, which fades but remains visible; a thoracotomy scar sits at the side. The repair does not always make the heart entirely normal: patches and valves may need monitoring, some people develop rhythm problems or a leaking valve in later life, and complex repairs may need reoperation. The goal is a stable heart that supports normal activity for as long as possible. A team should explain this honestly and, where relevant, discuss pregnancy planning, exercise advice and endocarditis prevention.
Risks and complications of congenital heart surgery
All heart surgery carries risk. Possible complications include bleeding, infection, abnormal heart rhythm, fluid around the lungs, kidney problems, stroke and, in some cases, a need for a pacemaker or further surgery. The chance of serious complications depends on the type of defect, the age, associated conditions and the experience of the team; the risk is higher for newborns and complex defects. The NHS, the British Heart Foundation and the American Heart Association publish plain explanations of congenital heart disease and its treatment. Ask the team for its own figures for the specific operation rather than accepting general statements.
How to choose a congenital heart team and what to ask
Look for a hospital with a congenital cardiac surgeon and a paediatric or congenital cardiologist, a dedicated cardiac intensive care unit, paediatric anaesthesia and perfusion services, and the ability to treat emergencies at any hour. Red flags include a firm quote with no images reviewed, no named surgeon, no figures for similar cases and pressure to decide quickly. Read how our process works and ask for an assessment through our free quote page.
- Which surgeon will operate, and how many of this operation does the team do each year?
- Does the hospital have a dedicated paediatric or congenital intensive care unit?
- What are the team's own results for this operation?
- Could a catheter procedure treat this defect instead?
- What does the package include, and what happens if the stay is longer?
- Who will follow up at home and how are records shared?
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
It is an operation that repairs a heart or large vessel defect present from birth, such as a hole between chambers, a narrowed aorta or misplaced vessels. It is done in infants, children and adults.
Outcomes have improved greatly and most children with common defects survive into adulthood after repair. Results for complex defects depend on the defect, the patient and the team, and some people need later procedures.
Approximate ranges are €8,000 to €35,000 in Turkey, against about €20,000 to €70,000 privately in the UK. Complex or staged operations and long intensive care stays can cost much more.
A straightforward repair usually means five to ten days in hospital. The chest heals over four to six weeks, and children often return to school after four to eight weeks if the team agrees.
Some can. Catheter procedures close certain holes, vessels and narrowings, but many defects need open repair. A congenital cardiologist and surgeon decide based on the images.
It carries real risks, including bleeding, infection, rhythm problems and stroke. Risk varies with the defect, age and team experience, so ask the hospital for its own results for this operation.
It depends on the defect. Some babies need surgery in the first weeks, others at several months or years, and small defects may only be watched. Adults can have surgery for defects found or changed later.
Only with clearance from the child's cardiologist. A plan for oxygen, medicines and English records is needed, and the hospital should confirm it can treat the specific defect.
Possibly. Patches, valves and conduits can wear or become too small as a child grows, and complex repairs often need reoperation. Lifelong cardiology follow-up is advised.
For a standard repair, families commonly stay three to six weeks: about a week in hospital and time nearby for check-ups before the flight home. Complex cases take longer.
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