Congenital Heart Defects

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Treatment

Congenital heart defects usually are treated by a pediatric cardiologist and possibly a cardiac surgeon. Treatment for congenital heart defects, whether they are detected at birth or later in life, may involve medication, surgery, or a combination of both.

Medications
A number of medicines may be used to treat congenital heart defects. Prostaglandin is a medication that is often used to help blood flow more easily through the lungs and body. This medication may be used until surgery can be performed to correct structural problems in the heart. In some cases, digoxin is prescribed to treat arrhythmias or congestive heart failure. Diuretics may be prescribed to reduce the amount of fluid in the body, which in turn can lower blood pressure and strain on the heart.

Antibiotics may be prescribed to prevent infection. Whenever the skin is pierced (e.g., during surgery or a dental procedure), bacteria can enter the bloodstream. Children with certain congenital heart defects are at increased risk for developing infections in the heart from bacteria that enter the bloodstream. Antibiotics that are given preventively are referred to as prophylactic antibiotics.

Parents and caregivers should speak with the child's physician about the risks and benefits of medications and should be sure to understand potential side effects.

Surgery

Open-heart Surgery (OHS)
In the United States, about 20,000 open-heart surgeries are performed in children each year. Of these 20,000 surgeries, about 70% of pediatric open-heart surgeries are performed on infants who are less than 1 year old and about 25% are performed in newborns who are less than 1 month of age.

Open-heart surgery involves connecting the child to a heart-lung bypass machine. This machine circulates blood through the lungs and body during the surgery. The beating of the heart is stopped with a cold potassium solution to allow the cardiac surgeon to repair defects.

The success of OHS depends on several factors, such as the overall health of the child and the type of defect to be repaired. Septal defects may have a lower risk for OHS repair and hypoplastic left heart syndrome has greater risks for OHS repair. Premature birth or other organ damage can increase the risks associated with OHS as well. Some congenital heart defects may require more than one open-heart surgery.

Heart Transplant
Approximately 150 heart transplants are performed in children each year in the United States. When there are no other medical alternatives available, heart transplant may be an option. Heart transplants are not a cure, but are a treatment that can extend life, as a transplanted heart generally does not last as long as a native heart. Patients who undergo a heart transplant must take immune suppressing medication for the rest of their lives.

Other Treatments

Cardiac catheterization can be used to treat congenital heart defects. Catheterization is a less invasive option than other forms of heart surgery and requires only a small puncture of the skin. Septal defects can be "patched" and valves that are too narrow can be widened using a catheter. Imaging technology such as echocardiogram may be used to help the physician guide and place the catheter in the necessary location. Children must be sedated during a catheterization procedure.

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