Congenital Heart Defects: When Surgery Can Help

Your baby develops at a rapid rate during pregnancy. When part of the body doesn’t develop properly, it’s known as a congenital defect. According to the National Institutes of Health, congenital heart defects (CHDs) are the most common of all birth defects.

Also known as congenital heart disease, these defects can occur in any pregnancy. That said, the risk of congenital heart issues increases if the mother has certain risk factors. These include:

• Having diabetes before becoming pregnant or developing diabetes in the first three months of pregnancy
• A family history of heart defects
• Smoking or being exposed to secondhand smoke during pregnancy
• Taking specific medications for high blood pressure or acne

Fortunately, surgery and other treatments limit complications and often help tiny babies grow into healthy adults who lead full lives.

When Congenital Heart Defects Require Treatment

Congenital heart defects only occur when something goes wrong. However, treatment isn’t always necessary — at least not immediately. Sometimes, children live their entire lives without ever treating congenital heart disease.

Timing and creating a fitting treatment plan depend on a few factors.

Types of Congenital Heart Defects

While some congenital heart problems never require treatment, others are critical. They often require immediate attention, including surgical intervention. Examples of critical types of congenital heart defects include:

• Dextro-Transposition of the great arteries (d-TGA). The position of the heart’s two main arteries is swapped. This can cause breathing problems, a weak pulse, and other worrisome symptoms.
• Hypoplastic left heart syndrome. This defect affects the left side of the heart and can result in a fast heart rate, bluish skin color, and other symptoms.
• Pulmonary atresia. With this congenital heart defect, the valve that allows the flow of blood between the heart and lungs is missing. Breathing problems and excessive sleepiness are two symptoms of this condition.
• Tetralogy of Fallot. The heart and its blood vessels experience four defects. These include an atypical hole between the lower chambers of the heart. The condition causes a heart murmur or bluish skin.
• Tricuspid atresia. When there is no tricuspid valve between the right atrium and right ventricle, the diagnosis is tricuspid atresia. A baby with this condition may not feed well, have bluish skin, and experience other problems.

Severity and Symptoms of the Defect

Treatment for less critical congenital heart defects depends on the severity and symptoms of the condition. Examples of conditions that may or may not need treatment include atrial and ventricular septal defects and patent ductus arteriosus.

• Atrial septal defects. The heart has two upper chambers, known as atria. An atrial septal defect is a hole in the wall between these chambers.
• Patent ductus arteriosus. The ductus arteriosus is a temporary artery that connects the body’s main artery (aorta) to the pulmonary arteries during development. If it doesn’t close after birth, it is patent ductus arteriosus.
• Ventricular septal defects. These are holes in the wall that separate the heart’s lower chambers (ventricles).

In some cases, no treatment is needed for these defects. The child doesn’t even experience symptoms. Over time, the holes close on their own, and all is well.

When the hole doesn’t close, it can affect the heart’s ability to function properly. This can result in a wide variety of problems. Your child may experience high blood pressure, fast breathing, difficulty eating and growing, or other problematic symptoms that can’t be ignored. If the hole is large or affects the child’s quality of life, medication or surgery helps provide relief.

Risk of Long-term Complications

Having a congenital heart defect increases the likelihood of dangerous complications, especially if left untreated. These may develop years after being born.

Potential complications, as reported by the American Heart Association, include:

• Atypical heart rhythm (arrhythmia)
• Blood clots
• Heart failure
• High blood pressure inside the arteries that lead to the lungs
• Inflammation in the inner lining of the heart or heart valves

Additionally, developmental delays and disorders may occur, and adults with congenital heart issues may experience pregnancy complications, blood clots, stroke, and more. Regular checkups and appropriate treatment can reduce the likelihood of these complications.

Common Surgeries That Address Congenital Heart Defects

Medication can help manage various heart defects, such as patent ductus arteriosus. Cardiac catheterization can help repair small atrial or ventricular septal defects. During catheterization, a pediatric interventional cardiologist guides a thin, flexible tube to the damaged area. The specialist then passes tiny tools through the tube, correcting the problem without a large incision.

More serious conditions benefit from cardiothoracic surgery. Based on your child’s needs, these procedures repair or replace damaged or missing heart valves, correct defective vessels, and more.

A few surgeries that help address congenital heart disease include:

• Arterial switch. To correct d-TGA, the misplaced arteries get repositioned where they belong, allowing the heart to function properly.
• Atrial or ventricular septal defect repair. Stitches or special patches close the hole between the heart’s upper or lower chambers.
• Hypoplastic left heart repair. Treating hypoplastic left heart requires three surgeries. The first takes place during the baby’s first two weeks of life and involves creating a new blood vessel to carry blood to the lungs and throughout the body.
• Patent ductus arteriosus closure. The surgeon finds the hole in the ductus arteriosus and ties off the damaged blood vessel.

Excellence in Congenital Heart Defect Care

At Driscoll Children’s Hospital, world-renowned experts use state-of-the-art technology and advanced surgical techniques to provide excellent surgical services and outcomes for children born with congenital heart defects.

Each year, the multidisciplinary team at the Heart Center cares for hundreds of cardiac patients. Despite caring for more high-risk patients than most facilities, our survival rate for congenital heart surgery patients is over 98%. Such high success rates place our program alongside the best in the country.

Additionally, our patients return home faster than the national average, so they can recover in the comfort of home, surrounded by loved ones.

Takeaways About Congenital Heart Defects

Here’s what you should remember about treating congenital heart defects to protect your child’s length and quality of life.

1. Though all heart defects are problematic, not all require immediate treatment. In fact, some don’t need any treatment at all.
2. To determine whether a defect needs treatment, your child’s team considers the type and severity of the heart defect, along with symptoms and risk of complications.
3. There are many surgical options to treat complex and common types of congenital heart defects, and Driscoll Children’s Hospital provides them all.

Are you experiencing a high-risk pregnancy that may result in a congenital heart defect or does your child have a defect that needs expert care? Find a doctor at Driscoll Children’s Hospital today.