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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.

Sometimes doctors combine catheter and surgical procedures to repair complex heart defects, which may involve several kinds of defects.

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. 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 increased 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 ASD repair, the doctor inserts a catheter into a vein in the groin (upper thigh). He or she threads the tube to the heart's septum. A device made up of two small disks or an umbrella-like device is attached to the catheter.

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 It’s secured in place and the catheter is withdrawn from the body.

Within 6 months, normal tissue grows in and over the device. The closure device does not need to be replaced as the child grows.

For pulmonary valve stenosis, the doctor inserts a catheter into a vein and threads it to the heart’s pulmonary valve. A tiny balloon at the end of the catheter is quickly inflated to push apart the leaflets, or "doors," of the valve.

Then, the balloon is deflated and the catheter and ballon are withdrawn.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), transesophageal (tranz-ih-sof-uh-JEE-ul) echo (TEE), and coronary angiography (an-jee-OG-rah-fee).

TEE is a special type of echo that takes pictures of the heart through the esophagus. The esophagus is the passage leading from the mouth to the stomach. Doctors also use TEE to examine complex heart 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.

Cardiac surgeons may use open-heart surgery to:

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

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. The heart has been donated by the deceased child’s family.

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July 1, 2011