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:
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. |