Materiały źródłowe

• #1 Conditions – Leeds Congenital Hearts

  https://leedscongenitalhearts.com/adult/conditions/view/4/24/transposition-of-the-great-arteries-arterial-switch

  Transposition of the great arteries is a serious heart condition in which the two main arteries arising from the heart are connected to the heart the wrong way round. Babies born with transposition of the great arteries will become blue shortly after birth and without heart surgery, the condition is usually fatal in the first year of life. […] All patients who have had a switch operation are at risk of infection in the heart (called endocarditis) after surgery. Such infections may be caused by infections of the teeth or gums, therefore it is important to visit the dentist regularly. You no longer require antibiotic cover with dental treatment. Body piercing and tattoos are best avoided as they also carry a small risk of infection which may spread to the heart. […] Because there may be a risk of early disease in the coronary arteries, we strongly advise against smoking. […] Talk to us before you get pregnant. This is to enable the cardiologist to assess your heart in more detail prior to pregnancy and to arrange further tests if necessary.

• #2 Transposition of the Great Arteries (TGA): Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/pediatrics/heart/transposition-of-the-great-arteries-tga

  Any baby can develop transposition of the great arteries. But mothers-to-be can take precautionary steps to have a healthy pregnancy, including: […] Speak with a specialist. If you are newly pregnant or planning to become pregnant, talk to a genetic counselor or cardiac specialist, especially if you have congenital heart defects in your family history or already have a child with TGA. […] Immunizations. Be sure to stay up to date on recommended vaccinations. […] Folic acid. Consider taking a multivitamin with 400 micrograms of folic acid. It may help prevent birth defects.

• #3 Transposition of the great arteries – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/transposition-of-the-great-arteries/symptoms-causes/syc-20350589

  If you have a family history of heart problems present at birth, consider talking with a genetic counselor and a health care provider experienced in congenital heart defects before getting pregnant. […] It’s important to take steps to have a healthy pregnancy. Before becoming pregnant, get recommended immunizations and start taking a multivitamin with 400 micrograms of folic acid.

• #4 Transposition of the Great Arteries – UF Health

  https://ufhealth.org/conditions-and-treatments/transposition-of-the-great-arteries

  Women who plan to become pregnant should be immunized against rubella if they are not already immune. Rubella infection in a pregnant woman can cause CHD. […] Women who are pregnant should get good prenatal care: […] Avoid alcohol and illegal drugs during pregnancy. […] Tell your provider that you are pregnant before taking any new medicines. […] Have a blood test early in your pregnancy to see if you are immune to rubella. If you are not immune, avoid any possible exposure to rubella and get vaccinated right after delivery. […] Pregnant women who have diabetes should try to get good control over their blood sugar level.

• #5

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/transposition-of-the-great-arteries

  Transposition of the great arteries occurs during pregnancy when the baby’s heart is developing. The cause is most often unknown. […] If you have a family history of heart problems present at birth, consider talking with a genetic counselor and a health care provider experienced in congenital heart defects before getting pregnant. […] It’s important to take steps to have a healthy pregnancy. Before becoming pregnant, get recommended immunizations and start taking a multivitamin with 400 micrograms of folic acid.

• #6 Transposition of the Great Arteries: Understanding Causes, Symptoms, and Treatment – Longmore Clinic

  https://longmoreclinic.org/transposition-of-the-great-arteries-understanding-causes-symptoms-and-treatment/

  Transposition of the Great Arteries is typically a result of complex developmental processes during pregnancy, there is often no definitive way to prevent it. […] However, pregnant individuals can take measures to minimize the risk of congenital heart defects, including: […] Regular prenatal visits and medical supervision are essential to monitor the developing fetus. […] Maintaining a healthy lifestyle, including a balanced diet and avoiding harmful substances, is crucial during pregnancy. […] If the mother has chronic conditions like diabetes, working closely with healthcare providers to manage them is essential.

• #7 Transposition of the Great Arteries – UF Health

  https://ufhealth.org/conditions-and-treatments/transposition-of-the-great-arteries

  Women who plan to become pregnant should be immunized against rubella if they are not already immune. Rubella infection in a pregnant woman can cause CHD. […] Women who are pregnant should get good prenatal care: […] Avoid alcohol and illegal drugs during pregnancy. […] Tell your provider that you are pregnant before taking any new medicines. […] Have a blood test early in your pregnancy to see if you are immune to rubella. If you are not immune, avoid any possible exposure to rubella and get vaccinated right after delivery. […] Pregnant women who have diabetes should try to get good control over their blood sugar level.

• #8 Transposition of the Great Arteries: Symptoms & Treatment – Victor Chang Cardiac Research Institute

  https://www.victorchang.edu.au/heart-disease/transposition-of-the-great-arteries

  Prevention of transposition of the great arteries (TGA) may not be possible, though it is advisable to reduce the risk of TGA by ensuring appropriate prenatal care. This includes quitting smoking, avoiding drinking alcohol and illicit drug use, ensuring immunisations are up to date, eating a healthy diet, taking any pregnancy supplements recommended by your doctor, and discussing any prescription medication use with your doctor.

• #9 D-transposition of the great arteries (D-TGA): Management and outcome – UpToDate

  https://www.uptodate.com/contents/d-transposition-of-the-great-arteries-d-tga-management-and-outcome

  Prenatal diagnosis of D-TGA improves survival as it allows for delivery at a tertiary center where pediatric cardiologists can make timely postnatal decisions regarding prostaglandin (alprostadil) infusion and the need for a balloon atrial septostomy (BAS) (figure 2) [1]. […] When the diagnosis of D-TGA is made prenatally, delivery should occur at a facility with a level III neonatal intensive care unit and pediatric cardiology expertise. If this is not feasible, transport arrangements should be established in advance of the delivery.

• #10 Managing transposition of the great arteries in the womb – Children’s National

  https://innovationdistrict.childrensnational.org/managing-transposition-of-the-great-arteries-in-the-womb/

  Fetal Cardiac Health Monitoring and managing fetuses heart health in the womb can greatly improve their chances of living long and productive lives. […] The condition may be fatal if something is not done immediately to reopen the fetal connections to stabilize the circulation before surgery can be done. […] While such a defect is fatal if left untreated, Dr. Donofrio explains there are two pathways that can allow the blood to get to where it needs to go such that the circulation is stabilized and the damage mitigated. […] By keeping those two pathways open, blood can cross from one side of the heart to the other, buying time in the delivery room so that babies can be stabilized before they receive surgery to permanently move the arteries back to their normal position. […] The cardiac intervention team immediately created a hole where the foramen ovale should have been by using a balloon to open the tissue that had closed. […] The care team also administered a prostaglandin infusion, a drug that can keep the ductus arteriosis open. […] Now, we can spot problems early and do something about it.

• #11 Managing transposition of the great arteries in the womb – Children’s National

  https://innovationdistrict.childrensnational.org/managing-transposition-of-the-great-arteries-in-the-womb/

  Fetal Cardiac Health Monitoring and managing fetuses heart health in the womb can greatly improve their chances of living long and productive lives. […] The condition may be fatal if something is not done immediately to reopen the fetal connections to stabilize the circulation before surgery can be done. […] While such a defect is fatal if left untreated, Dr. Donofrio explains there are two pathways that can allow the blood to get to where it needs to go such that the circulation is stabilized and the damage mitigated. […] By keeping those two pathways open, blood can cross from one side of the heart to the other, buying time in the delivery room so that babies can be stabilized before they receive surgery to permanently move the arteries back to their normal position. […] The cardiac intervention team immediately created a hole where the foramen ovale should have been by using a balloon to open the tissue that had closed. […] The care team also administered a prostaglandin infusion, a drug that can keep the ductus arteriosis open. […] Now, we can spot problems early and do something about it.

• #12 Transposition of the Great Arteries | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/transposition

  The immediate management of an infant with transposition focuses on getting safe oxygen levels. Stable cardiac and pulmonary function is important. […] A continuous infusion of prostaglandin, a medication that will keep the ductus arteriosus open, is usually started when the diagnosis is suspected or confirmed. This will allow some mixing of oxygen-rich blood with oxygen-poor blood. […] A procedure called a „balloon atrial septostomy” is often done once the diagnosis is confirmed. […] Surgical correction of the defect is always needed. In most cases, corrective surgery is done in the first week of life. […] In most cases of transposition, an arterial switch surgery is done. The arterial switch surgery involves cutting off the aorta and pulmonary arteries just above the point where they leave the heart. […] All patients with transposition of the great arteries need to be followed by a congenital heart expert for life.

• #13

  https://www.nhs.uk/conditions/congenital-heart-disease/treatment/

  As with treatment for single ventricle defects, your baby will be given an injection of a medication called prostaglandin shortly after birth. This will prevent the passage between the aorta and pulmonary arteries (the ductus arteriosus) closing after birth. […] Keeping the ductus arteriosus open means that oxygen-rich blood is able to mix with oxygen-poor blood, which should help relieve your baby’s symptoms. […] In some cases, it may also be necessary to use a catheter to create a temporary hole in the atrial septum (the wall separating the 2 upper chambers of the heart) to further encourage the mixing of blood. […] Once your baby’s health has stabilized, it’s likely that surgery will be recommended. This should ideally be carried out during the first month of the baby’s life. A surgical technique called arterial switch is used, which involves detaching the transposed arteries and reattaching them in the correct position.

• #14 Transposition of the Great Arteries Medication: Inotropic agents, Loop diuretics, Prostaglandins

  https://emedicine.medscape.com/article/900574-medication

  Transposition of the great arteries (TGA) has no specific or recommended drug therapies. Newborn infants with transposition of the great arteries (particularly those with severe left ventricular outflow tract obstruction) may benefit from alprostadil (ie, prostaglandin E1) therapy. […] All patients require antibiotic prophylaxis prior to dental and indicated surgical procedures in order to reduce the risk of subacute bacterial endocarditis. Thus, all patients require preoperative and postoperative antibiotic prophylaxis for dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa. Antibiotic prophylaxis is also recommended for invasive respiratory tract procedures that involve incision or biopsy of the respiratory mucosa (eg, tonsillectomy, adenoidectomy). […] See the endocarditis prophylaxis guidelines that were revised by the American Heart Association (AHA).

• #15 Managing transposition of the great arteries in the womb – Children’s National

  https://innovationdistrict.childrensnational.org/managing-transposition-of-the-great-arteries-in-the-womb/

  Fetal Cardiac Health Monitoring and managing fetuses heart health in the womb can greatly improve their chances of living long and productive lives. […] The condition may be fatal if something is not done immediately to reopen the fetal connections to stabilize the circulation before surgery can be done. […] While such a defect is fatal if left untreated, Dr. Donofrio explains there are two pathways that can allow the blood to get to where it needs to go such that the circulation is stabilized and the damage mitigated. […] By keeping those two pathways open, blood can cross from one side of the heart to the other, buying time in the delivery room so that babies can be stabilized before they receive surgery to permanently move the arteries back to their normal position. […] The cardiac intervention team immediately created a hole where the foramen ovale should have been by using a balloon to open the tissue that had closed. […] The care team also administered a prostaglandin infusion, a drug that can keep the ductus arteriosis open. […] Now, we can spot problems early and do something about it.

• #16 Transposition of the Great Arteries | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/transposition

  The immediate management of an infant with transposition focuses on getting safe oxygen levels. Stable cardiac and pulmonary function is important. […] A continuous infusion of prostaglandin, a medication that will keep the ductus arteriosus open, is usually started when the diagnosis is suspected or confirmed. This will allow some mixing of oxygen-rich blood with oxygen-poor blood. […] A procedure called a „balloon atrial septostomy” is often done once the diagnosis is confirmed. […] Surgical correction of the defect is always needed. In most cases, corrective surgery is done in the first week of life. […] In most cases of transposition, an arterial switch surgery is done. The arterial switch surgery involves cutting off the aorta and pulmonary arteries just above the point where they leave the heart. […] All patients with transposition of the great arteries need to be followed by a congenital heart expert for life.

• #17 Transposition of the Great Arteries (TGA) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/transposition-of-the-great-arteries-tga

  Endocarditis prophylaxis is recommended preoperatively but is required only for the first 6 months after repair unless there is a residual defect adjacent to a surgical patch or prosthetic material. […] Relieve cyanosis by giving prostaglandin E1 infusion to keep the ductus arteriosus open and sometimes by using a balloon catheter to enlarge the foramen ovale. […] Do definitive surgical repair during the first week of life.

• #18

  https://www.nhs.uk/conditions/congenital-heart-disease/treatment/

  As with treatment for single ventricle defects, your baby will be given an injection of a medication called prostaglandin shortly after birth. This will prevent the passage between the aorta and pulmonary arteries (the ductus arteriosus) closing after birth. […] Keeping the ductus arteriosus open means that oxygen-rich blood is able to mix with oxygen-poor blood, which should help relieve your baby’s symptoms. […] In some cases, it may also be necessary to use a catheter to create a temporary hole in the atrial septum (the wall separating the 2 upper chambers of the heart) to further encourage the mixing of blood. […] Once your baby’s health has stabilized, it’s likely that surgery will be recommended. This should ideally be carried out during the first month of the baby’s life. A surgical technique called arterial switch is used, which involves detaching the transposed arteries and reattaching them in the correct position.

• #19 Conditions – Leeds Congenital Hearts

  https://leedscongenitalhearts.com/adult/conditions/view/4/24/transposition-of-the-great-arteries-arterial-switch

  Transposition of the great arteries is a serious heart condition in which the two main arteries arising from the heart are connected to the heart the wrong way round. Babies born with transposition of the great arteries will become blue shortly after birth and without heart surgery, the condition is usually fatal in the first year of life. […] All patients who have had a switch operation are at risk of infection in the heart (called endocarditis) after surgery. Such infections may be caused by infections of the teeth or gums, therefore it is important to visit the dentist regularly. You no longer require antibiotic cover with dental treatment. Body piercing and tattoos are best avoided as they also carry a small risk of infection which may spread to the heart. […] Because there may be a risk of early disease in the coronary arteries, we strongly advise against smoking. […] Talk to us before you get pregnant. This is to enable the cardiologist to assess your heart in more detail prior to pregnancy and to arrange further tests if necessary.

• #20 d-Transposition of the Great Arteries | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/d-transposition-of-the-great-arteries

  Children who have transposition of the great arteries are at increased risk for endocarditis. Some children will need to take antibiotics before certain dental procedures. […] People who have transposition of the great arteries and had atrial switch operations require endocarditis prophylaxis. Most patients who underwent simple arterial switch procedures won’t need prophylaxis. Your cardiologist will be able to determine if you need to keep taking routine antibiotics before certain dental work.

• #21 l-Transposition of the Great Arteries | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/l-transposition-of-the-great-arteries

  People who have l-transposition of the great arteries may require endocarditis prophylaxis if they have a prosthetic valve. […] In the majority of patients, there is no prosthetic valve and the cardiologist will be able to determine if the patient needs to keep taking routine antibiotics before certain dental work. […] A cardiologist with expertise in managing adults with congenital heart disease should evaluate you regularly, at least once a year and more often if you have symptoms. […] You should also consult a cardiologist with expertise in caring for adults with congenital heart disease if you are undergoing any type of non-heart surgery or invasive procedure.

• #22 Transposition of the Great Arteries Medication: Inotropic agents, Loop diuretics, Prostaglandins

  https://emedicine.medscape.com/article/900574-medication

  Transposition of the great arteries (TGA) has no specific or recommended drug therapies. Newborn infants with transposition of the great arteries (particularly those with severe left ventricular outflow tract obstruction) may benefit from alprostadil (ie, prostaglandin E1) therapy. […] All patients require antibiotic prophylaxis prior to dental and indicated surgical procedures in order to reduce the risk of subacute bacterial endocarditis. Thus, all patients require preoperative and postoperative antibiotic prophylaxis for dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa. Antibiotic prophylaxis is also recommended for invasive respiratory tract procedures that involve incision or biopsy of the respiratory mucosa (eg, tonsillectomy, adenoidectomy). […] See the endocarditis prophylaxis guidelines that were revised by the American Heart Association (AHA).

• #23 Transposition of the Great Arteries (TGA) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/transposition-of-the-great-arteries-tga

  Endocarditis prophylaxis is recommended preoperatively but is required only for the first 6 months after repair unless there is a residual defect adjacent to a surgical patch or prosthetic material. […] Relieve cyanosis by giving prostaglandin E1 infusion to keep the ductus arteriosus open and sometimes by using a balloon catheter to enlarge the foramen ovale. […] Do definitive surgical repair during the first week of life.

• #24 Transposition of the Great Arteries | Condition Overview | Columbia Surgery

  https://columbiasurgery.org/conditions-and-treatments/transposition-of-the-great-arteries

  Surgical treatment is typically required immediately to widen or create openings to allow oxygen-rich blood to travel to the rest of the body. After treatment, follow-up care will usually be needed to prevent further complications. […] After surgery, ongoing monitoring and medications may be needed to manage additional complications, such as high blood pressure, irregular heartbeats, and extra fluid. If the heart is beating too slow, a pacemaker may have to be installed. […] However, children who receive surgical repair for TGA will require lifelong care and supervision by a cardiologist. Regular follow-ups may include imaging tests to check for any possible defects or complications of the heart as well as exercise stress tests to determine how well the heart is functioning. In particular, doctors will look for excessive narrowing (coarctation) where blood vessels have been sewn together and valve defects, such as leakage. Additional surgeries may be required as the child grows.

• #25 About dextro-Transposition of the Great Arteries (d-TGA) | Congenital Heart Defects (CHDs) | CDC

  https://www.cdc.gov/heart-defects/about/d-tga.html

  Surgical repairs for d-TGA are not a cure. People with d-TGA should schedule routine checkups with a heart doctor to stay as healthy as possible. […] Surgery is required for all babies born with d-TGA. This will help maintain, enlarge, or create openings that will deliver oxygen-rich blood to the body. […] After surgery, medications may be needed to help the heart pump better, control blood pressure, help get rid of extra fluid in the body, and slow down the heart if it is beating too fast. […] Infants who have surgical repairs for d-TGA are not cured. They may have lifelong complications. A child or adult with d-TGA will need regular follow-up visits with a cardiologist (a heart doctor) to monitor their progress and avoid complications or other health problems.

• #26 Transposition of the Great Arteries | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/transposition

  The immediate management of an infant with transposition focuses on getting safe oxygen levels. Stable cardiac and pulmonary function is important. […] A continuous infusion of prostaglandin, a medication that will keep the ductus arteriosus open, is usually started when the diagnosis is suspected or confirmed. This will allow some mixing of oxygen-rich blood with oxygen-poor blood. […] A procedure called a „balloon atrial septostomy” is often done once the diagnosis is confirmed. […] Surgical correction of the defect is always needed. In most cases, corrective surgery is done in the first week of life. […] In most cases of transposition, an arterial switch surgery is done. The arterial switch surgery involves cutting off the aorta and pulmonary arteries just above the point where they leave the heart. […] All patients with transposition of the great arteries need to be followed by a congenital heart expert for life.

• #27 l-Transposition of the Great Arteries | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/l-transposition-of-the-great-arteries

  People who have l-transposition of the great arteries may require endocarditis prophylaxis if they have a prosthetic valve. […] In the majority of patients, there is no prosthetic valve and the cardiologist will be able to determine if the patient needs to keep taking routine antibiotics before certain dental work. […] A cardiologist with expertise in managing adults with congenital heart disease should evaluate you regularly, at least once a year and more often if you have symptoms. […] You should also consult a cardiologist with expertise in caring for adults with congenital heart disease if you are undergoing any type of non-heart surgery or invasive procedure.

• #28 About dextro-Transposition of the Great Arteries (d-TGA) | Congenital Heart Defects (CHDs) | CDC

  https://www.cdc.gov/heart-defects/about/d-tga.html

  Surgical repairs for d-TGA are not a cure. People with d-TGA should schedule routine checkups with a heart doctor to stay as healthy as possible. […] Surgery is required for all babies born with d-TGA. This will help maintain, enlarge, or create openings that will deliver oxygen-rich blood to the body. […] After surgery, medications may be needed to help the heart pump better, control blood pressure, help get rid of extra fluid in the body, and slow down the heart if it is beating too fast. […] Infants who have surgical repairs for d-TGA are not cured. They may have lifelong complications. A child or adult with d-TGA will need regular follow-up visits with a cardiologist (a heart doctor) to monitor their progress and avoid complications or other health problems.

• #29 Transposition of the Great Arteries | Condition Overview | Columbia Surgery

  https://columbiasurgery.org/conditions-and-treatments/transposition-of-the-great-arteries

  Surgical treatment is typically required immediately to widen or create openings to allow oxygen-rich blood to travel to the rest of the body. After treatment, follow-up care will usually be needed to prevent further complications. […] After surgery, ongoing monitoring and medications may be needed to manage additional complications, such as high blood pressure, irregular heartbeats, and extra fluid. If the heart is beating too slow, a pacemaker may have to be installed. […] However, children who receive surgical repair for TGA will require lifelong care and supervision by a cardiologist. Regular follow-ups may include imaging tests to check for any possible defects or complications of the heart as well as exercise stress tests to determine how well the heart is functioning. In particular, doctors will look for excessive narrowing (coarctation) where blood vessels have been sewn together and valve defects, such as leakage. Additional surgeries may be required as the child grows.

• #30 Conditions – Leeds Congenital Hearts

  https://leedscongenitalhearts.com/adult/conditions/view/4/24/transposition-of-the-great-arteries-arterial-switch

  Transposition of the great arteries is a serious heart condition in which the two main arteries arising from the heart are connected to the heart the wrong way round. Babies born with transposition of the great arteries will become blue shortly after birth and without heart surgery, the condition is usually fatal in the first year of life. […] All patients who have had a switch operation are at risk of infection in the heart (called endocarditis) after surgery. Such infections may be caused by infections of the teeth or gums, therefore it is important to visit the dentist regularly. You no longer require antibiotic cover with dental treatment. Body piercing and tattoos are best avoided as they also carry a small risk of infection which may spread to the heart. […] Because there may be a risk of early disease in the coronary arteries, we strongly advise against smoking. […] Talk to us before you get pregnant. This is to enable the cardiologist to assess your heart in more detail prior to pregnancy and to arrange further tests if necessary.

• #31 l-Transposition of the Great Arteries | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/l-transposition-of-the-great-arteries

  People who have l-transposition of the great arteries may require endocarditis prophylaxis if they have a prosthetic valve. […] In the majority of patients, there is no prosthetic valve and the cardiologist will be able to determine if the patient needs to keep taking routine antibiotics before certain dental work. […] A cardiologist with expertise in managing adults with congenital heart disease should evaluate you regularly, at least once a year and more often if you have symptoms. […] You should also consult a cardiologist with expertise in caring for adults with congenital heart disease if you are undergoing any type of non-heart surgery or invasive procedure.

• #32 About dextro-Transposition of the Great Arteries (d-TGA) | Congenital Heart Defects (CHDs) | CDC

  https://www.cdc.gov/heart-defects/about/d-tga.html

  Surgical repairs for d-TGA are not a cure. People with d-TGA should schedule routine checkups with a heart doctor to stay as healthy as possible. […] Surgery is required for all babies born with d-TGA. This will help maintain, enlarge, or create openings that will deliver oxygen-rich blood to the body. […] After surgery, medications may be needed to help the heart pump better, control blood pressure, help get rid of extra fluid in the body, and slow down the heart if it is beating too fast. […] Infants who have surgical repairs for d-TGA are not cured. They may have lifelong complications. A child or adult with d-TGA will need regular follow-up visits with a cardiologist (a heart doctor) to monitor their progress and avoid complications or other health problems.

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