Living With Holes in the Heart

The outlook for children with atrial septal defects (ASDs) and ventricular septal defects (VSDs) is excellent. Advances in treatment mean that most children with these heart defects have normal, active, and productive lives with no decrease in lifespan.

Many children with these defects need no special care or only occasional checkups with a cardiologist (a doctor who specializes in heart problems) as they go through childhood and adult life.

Living With an Atrial Septal Defect

Small ASDs often close on their own, and children with these heart defects don't have any problems or need treatment. Children and adults with small ASDs that don't close and don't cause symptoms are healthy and don't need treatment.

Many others with ASDs that don't close undergo procedures to close the hole and prevent possible long-term complications. Children recover well from these procedures and lead normal, healthy lives. Adults also do well after closure procedures.

Medical Needs

Arrhythmias. The risk of arrhythmias (irregular heartbeats) increases before and after surgery. Adults with ASDs who are older than 40 years are especially likely to have arrhythmias. People who had arrhythmias before surgery are more likely to have them after surgery.

Followup care. Regular followup care into adult life is advised for those who have had:

• An ASD repaired as an adult
• Arrhythmias before and after surgery
• An ASD repaired with a catheter procedure
• High blood pressure in the pulmonary artery at the time of surgery

Antibiotics. Some heart defects and their repairs can increase the risk of bacterial endocarditis, a serious infection of the heart valves or lining of the heart. You may need antibiotics before medical or dental procedures (such as surgery or dental cleanings) that could allow bacteria to enter your bloodstream. Talk to your doctor about whether you need to take antibiotics before such procedures. ASDs aren't associated with the risk of endocarditis, except in the 6 months after repair (for both catheter procedures and surgery).

Special Considerations for Children and Teens

Activity. Children with a repaired or closed ASD have no restrictions on their activity.

Growth and development. Children with ASDs don't have growth or development problems.

Regular health care. Your child should see his or her regular doctor for routine health care.

Additional surgery or procedures. When a child has an ASD, but no other heart defect, additional surgery isn't needed.

Special Considerations for Adults

Recovery from surgical repair of an ASD. When an ASD is repaired in adult life, the cardiologist or surgeon will explain what to expect during the recovery period and when to return to driving, working, exercising, and other activities.

Living With a Ventricular Septal Defect

Children with small VSDs have no symptoms and need only rare followup with a cardiologist. To protect these children from endocarditis, they may need antibiotics before medical or dental procedures (such as surgery or dental cleanings) that could allow bacteria to enter the bloodstream. Talk to your child's doctor about whether your child needs to take antibiotics before such procedures.

Children and adults who have had successful repair of a VSD and have no other congenital heart defects can expect to lead normal, healthy, and active lives.

Medical Needs

Sometimes problems and risks remain after surgical closure. They include:

• Arrhythmias (irregular heartbeats). Serious and frequent arrhythmias require regular medical followup. The risk of arrhythmia is greater if surgery is done later in life.
• Residual or remaining VSD. This is usually due to a leak at the edge of the patch used to close the hole. These VSDs tend to be very small and don't cause problems. They very rarely require another operation.

Antibiotics. People who have VSDs are at increased risk for bacterial endocarditis. Antibiotic treatment to prevent bacterial endocarditis may be recommended after VSD surgery. Residual VSDs or small VSDs that don't need surgery may require treatment with antibiotics before medical or dental procedures (such as surgery or dental cleanings) that could allow bacteria to enter the bloodstream. Talk to your doctor about whether you need to take antibiotics before such procedures.

Special Considerations for Children and Teens

Activity. There should be no activity restrictions on a child with a small VSD that doesn't need surgery, or after recovery from VSD repair. Be sure to check with your child's doctor about whether your child can take part in sports.

Growth and development. Your pediatrician or family doctor checks your child for growth and development at each routine checkup. Babies with large VSDs may not grow as quickly as other infants. These babies usually catch up after the VSD is closed.

Regular health care. Your child should see his or her regular doctor for routine health care.

Additional surgery or procedures. Teens and young adults rarely need additional surgery once a VSD closes or is repaired.