Congenital heart defects include structural problems with the heart that are present since birth. These defects can involve:
Heart defects cause change in the normal flow of blood through the heart and/or blood flow throughout the body.They range from simple defects with no/minimal symptoms to complex defects with severe, life-threatening symptoms. Many of these defects are simple conditions that are easily fixed, only require serial monitoringand no treatment. A small number of babies are however born with complex congenital heart defects that require special medical care soon after birth. The diagnosis and treatment of these complex defects has greatly improved with increased usage of fetal echocardiography and other modern day imaging and testing. As a result, almost all children who have complex heart defects are able to get treatment either in utero or soon after birth and are able to survive to adulthood.Few people who have severe complex heart defects may however continue to need special heart care throughout their lives. They may need to pay special attention to how their condition may affect certain issues, such as fitness, employment, pregnancy, contraception, and other health issues.
Some heart defects do not have signs and symptoms at birth but become symptomatic as child grows. The age of presentation and severity of symptoms in such casesdepends on the number, type, and severity of the defects. Severe or multiple concomitant defects can have signs and symptoms since birth or few hours after birth. These signs and symptoms may include:
Simple congenital heart disease includes defects such as a hole in atrial or ventricular septum or communication between aorta and pulmonary artery that allows blood to flow from left to right side of the heart. This category also includes defects with a congenitally acquired narrowing ofheart valve or blood flow pathway that blocks blood flow to the lungs or other parts of the body.
Children with these type of heart defects usually present with breathing difficulties, repeated chest infections, poor weight gain, poor milestones, easy fatigability and symptoms of heart failure. Definitive corrective surgeries if performed at appropriate time in such cases yield good immediate and long-term results and have good prognosis.
Complex congenital heart defects are combination of two or more defects which needs to be repaired surgically or in association with intervention cardiology. Surgery may be single staged or multiple staged depending on complexity of defect. Few defects require immediate corrective surgery after birth and others require corrective surgery after few months or years depending on the condition of child.
Catheter procedures are minimally invasive procedures and are much easier to be performed on patients than surgery because they involve only a needle puncture in the skin where the catheter (thin, flexible tube) is inserted into a vein or an artery and an occlude device is implanted to close the hole or to open obstruction in obstructive defects. The use of catheter procedures has grown a lot in the past 20 years. They have become the procedure of choice to repair many simple heart defects, such as atrialseptaldefect (ASD), Ventricular septal defect(VSD), pulmonary/aorticvalvestenosis and coarctation of aorta and patent ductus arteriosus.
A child may need open-heart surgery if the nature of the heart defect is complex or his or her simple heart defect can't be fixed using a catheter procedure. Usually, one surgery can repair the defect completely, however children with complex congenital heart defects may require many more serial surgeries over months or years to fix their problem.
Open-heart surgery may be done to:
Rarely, babies are born with multiple defects that are too complex to repair. These babies may eventually become candidates for heart transplants. In this procedure, the child's heart is replaced with a healthy heart from a deceased child that has been donated by that child's family.
