If your child was born with the problem in the heart’s structure, it means he has been diagnosed with a congenital heart defect. Some congenital defects do not need any treatment such as a very small hole between heart chambers which closes on its own but some defects are too complex that may require surgeries over a period of few years.
Patent ductus arteriosus (PDA)
Patent ductus arteriosus (PDA) occurs when the opening called ductus arteriosus does not close even after birth. Ductus arteriosus is a blood vessel between the main artery to the body and the main artery to the lungs. A small PDA does not cause problems without any treatment but a large PDA can cause the flow of poorly oxygenated blood through the heart that results in weakening of the heart muscle and can cause even heart failure. Therefore, treatment of this defect is must. The major symptoms of this defect are your child is becoming breathless when crying or tiring easily when playing or not gaining weight or turning blue when eating. Sometimes PDA can be closed with the medicines or the procedure that does not involve surgery. But if medicines fail, then a surgical method is being opted in which a small cut is made on the left side of the chest and then, the ductus arteriosus is tied or clipped off.
Coarctation of the aorta
It is a situation in which the large blood vessel that branches off the heart and delivers oxygen rich blood to the body starts narrowing. This situation is called as Coarctation of the aorta. It may range from mild to severe. Irritability, difficulty in breathing, pale skin, heavy sweating, hypertension and nosebleeds are the major symptoms of this defect in the children caused by this defect. Making a cut on the narrower section and the patch made of Gore-tex makes the cut bigger is the common way to repair this defect. In the older children, after removing the narrow section, the remaining ends are stitched together. In the latest method surgery is not required in which a small balloon is opened up in the narrow area by leaving a stent there to keep the artery open.
Atrial septal defect (ASD)
While the baby is in the womb, ASD is a hole in the wall between the two upper chambers of the heart. During early childhood, smaller ASD may close on its own but long-standing ASD can shorten the life span due to heart failure or high blood pressure in the lungs. Fatigue, swelling of legs, murmuring sound of heart, frequent lung infections is the major symptoms of this defect. A developed procedure is being now adopted to close ASD without surgery. The surgeons makes a tiny surgical cut and then inserts an ASD closure device i.e. catheters into the heart that results in the closure of ASD. ASD’s less than 5mm close on its own while 8 to 10 mm ASD may need a procedure.
Ventricular septal defect
This defect involves one or more openings in the wall that separates the left and right ventricles of your heart that allow mixing of oxygen-rich and oxygen-poor blood. Person who have small hole may not have the symptoms but if the hole is large, the most common symptoms include a bluish tint to the lips, skin and fingernails, fast breathing, rapid heart rate and poor eating. Usually, heart reveals a murmur sound i.e. sound of blood crossing the opening listening with the stethoscope. The loudness of the sound is directly related to the size of the defect. Medications such as digitalis and diuretics may help to control the symptoms and surgery but even with medication symptoms continue then, surgery with a Gore-tex patch is needed to close the defect. Contact a professional health care provider immediately if your child is having any kind of the symptoms.
Tetralogy of Fallot
This defect is caused by a rare combination of four heart defects that are present at the time of birth. Those four defects are Ventricular Septal Defect (VSD), thickened wall of the right ventricle, aorta shifted over the VSD and the right ventricle instead of coming out from the left ventricle only and narrowing of the pulmonary outflow tract. The major signs of this defect are a bluish colour of the skin, fainting, clubbing of fingers and toes, poor weight gain and tiring easily while playing. More than one surgery may be needed if single surgery does not work. In first few months of the life, one corrective surgery is done to close the VSD and widen the part of narrowed pulmonary tract. And at a later time, another surgery may be done to correct the defect. Death usually occurs without surgery by the age 20. If you see any symptom in your baby, calm the baby and seek a health care provider immediately.
Transposition of the great vessels
In this heart defect, the two major vessels i.e. the pulmonary artery and the aorta that carry blood away from the heart are transposed (switched). This defect occurs from the birth in which blood is pumped from the heart to the rest of the body with decreased oxygen. The nature of the symptoms depends on the size of the defect however; the common symptoms are breath shortening, poor feeding, blue skin and clubbing of fingers or toes. To permanently correct this defect within the first week of life of the baby, a surgery called arterial switch procedure is done in which both the arteries are switched back to its normal position.
It is rare heart defect at birth in which a single large blood vessel comes out of the heart instead of two normal separate vessels i.e. aorta and pulmonary artery. In addition, a wall is missing that divides two lower chambers of the heart that results oxygen-poor blood and oxygen-rich blood are mixed together. The major signs that develop in first few weeks are blue coloration of the skin, excess sweating, poor growth, excess sleeping, widening of finger tips and irregular heartbeats. To correct this rare defect, a surgery is needed in which two separate arteries are created i.e. a new pulmonary artery is made from tissue and the truncal vessel is keeping as the new aorta. The hole between the chambers is closed by sewing the branch pulmonary arteries to the new artery. Surgery to repair this defect is generally successful especially when the treatment is done before the age of 2 months of your baby.
It is a type of heart defect that is present at birth, in which tricuspid valve between the two heart chambers is abnormally developed or not formed due to which blood cannot flow through the heart into the lungs for picking up the oxygen. Soon after birth, the evident of this defect include blue-tinged skin, easily tiring during feeding, poor growth and difficulty in breathing. In this condition, surgery is must. The first surgery occurs usually within the first few days in which an artificial shunt is inserted to keep continuing flow of blood to the lungs. In the second stage called hemifontan procedure in which half of the veins carrying the blue blood are connected from the upper half of the body to the pulmonary artery directly and the final step called fontan procedure connects the rest of the veins carrying the blue blood to the pulmonary artery leading to the lungs. The second step is taken when the child is between 4-6 months and the final step is taken when the child is 18 months to 3 years old. Contact a medical professional immediately, if your child has new changes in patterns of breathing or skin that is turning blue.
Total anomalous pulmonary venous return
It is a congenital heart defect in which none of the four veins is attached to the left upper chamber of the heart that carries blood from the lungs to the heart. The infant may have frequent respiratory infections, blue skin, poor growth and poor feeding. As soon as possible, surgery is required which connects the pulmonary veins to the left upper chamber of the heart and the defect is closed. If this defect is not repaired on time, then, the heart will get larger and will lead to heart failure. Prompt attention is needed when you notice the symptoms in your child.
Hypoplastic left heart syndrome
This rare and complex defect presents at birth in which left side of the heart i.e. left ventricle, mitral valve, aorta and aortic valve are critically underdeveloped. In this condition, the right side has to bear extra workload because it has to maintain the circulation for the lungs as well as the body which can eventually cause failure. That is why; surgery is must for this defect. Immediately after the birth, baby can be affected by greyish-blue skin colour, cool body, being inactive, pounding heart and rapid breathing. Baby will be admitted to NIC unit after diagnosis is made. There are three steps in the treatment procedure. Within the first few days of baby’s life, Norwood operation, the first step is taken which consists of building a new aorta. After the suggestion of pediatric cardiologist, the second step is taken called hemi-fontan procedure in which the major vein with blue blood is connected from the top half of the body to the pulmonary arteries to get oxygen. And then, the final step called fontan procedure is taken which connects the rest of the veins from the body to the blood vessels to the lungs. However, if a donated heart is available for small infants then, heart transplantation is a better choice as compared to this three step procedure.