How Are Congenital Heart Defects Treated?
Although many children with congenital heart defects
dont need treatment, some do. Doctors treat congenital heart defects
with:
- Procedures using catheters to repair the defect
- Surgery to repair the defect
The treatment your child receives depends on the
type and severity of his or her heart defect. Other factors include your
childs age, size, and general health. Treatment can be simple or very
complex. Some children with complex congenital heart defects may need several
catheter or surgical procedures over a period of years, or may need to take
medicines for years.
Procedures Using Catheters
Catheter procedures are much easier than surgery on
patients because they involve only a needle puncture in the skin where the
catheter is inserted into a vein or an artery. Doctors dont have to
surgically open the chest or operate directly on the heart to repair the
defect. This means that recovery can be much 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. The doctor inserts the catheter through a vein and threads
it up 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 and 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 The device is secured in place and the catheter is then withdrawn from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.
- Pulmonary valve stenosis. The doctor inserts the
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the catheter is withdrawn. Procedures like this can be used to repair any
narrowed valve in the heart.
Doctors often use an
echocardiogram
or a transesophageal (trans-e-SOF-ah-ge-al) echocardiogram (TEE) as well as an
angiogram
to guide them in threading the catheter and doing the repair. A TEE is a
special type of echocardiogram that takes pictures of the back of the heart
through the esophagus (the tube leading from the mouth to the stomach). TEE
also is often used to define complex heart defects.
Catheter procedures also are sometimes used during
surgery to help repair complex defects.
Surgery
A child may need open-heart surgery if his or her
heart defect cant be fixed using a catheter procedure. Sometimes, one
surgery can repair the defect completely. If thats not possible, a child
may need more than one surgery over a period of 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 and how they develop
Rarely, babies are born with multiple defects that
are too complex to repair. These babies may need a heart transplant. In this
procedure, the childs heart is replaced with a healthy heart from a
deceased child that has been donated by that childs family. |