How Are Congenital Heart Defects Treated?

Although many children who have congenital heart defects don't need treatment, some do. Doctors repair congenital heart defects with catheter procedures or surgery.

The treatment your child receives depends on the type and severity of his or her heart defect. Other factors include your child's age, size, and general health.

Some children who have complex congenital heart defects may need several catheter or surgical procedures over a period of years, or they may need to take medicines for years.

Catheter Procedures

Catheter procedures are much easier 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.

Doctors don't have to surgically open the chest or operate directly on the heart to repair the defect(s). This means that recovery may be easier and quicker.

The use of catheter procedures has grown a lot in the past 20 years. They have become the preferred way to repair many simple heart defects, such as atrial septal defect (ASD) and pulmonary valve stenosis.

For an ASD, the doctor inserts a catheter through a vein and threads it into the heart to the septum. The catheter has a tiny, umbrella-like device folded up inside it.

When the catheter reaches the septum, the device is pushed out of the catheter. It's positioned so that it plugs the hole between the atria. The device is secured in place and the catheter is then withdrawn from the body.

For pulmonary valve stenosis, the doctor inserts a catheter through a vein and threads it into the heart to the pulmonary valve. A tiny balloon at the end of the catheter is quickly inflated to push apart the leaflets, or "doors," of the valve. The balloon is then deflated and the catheter and ballon are withdrawn. This procedure can be used to repair any narrowed valve in the heart.

To help guide the catheter, doctors often use echocardiography (echo) or transesophageal (tranz-ih-sof-uh-JEE-ul) echocardiography (TEE) and angiography (an-jee-OG-ra-fee).

TEE is a special type of echo that takes pictures of the back of the heart through the esophagus (the passage leading from the mouth to the stomach). TEE also is often used to examine complex heart defects.

Doctors also sometimes combine catheter and surgical procedures to repair complex heart defects, which may involve several kinds of defects.

Surgery

A child may need open-heart surgery if his or her heart defect can't be fixed using a catheter procedure. Sometimes, one surgery can repair the defect completely. If that's not possible, the child may need more surgeries over months or years to fix the problem.

Open-heart surgery may be done to:

• Close holes in the heart with stitches or with a patch
• Repair or replace heart valves
• Widen arteries or openings to heart valves
• Repair complex defects, such as problems with where the blood vessels near the heart are located or how they developed 

Rarely, babies are born with multiple defects that are too complex to repair. These babies may need 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.