Treatment

Doctors treat congenital heart defects with:

• Medicines
• Special procedures using catheters
• Surgery
• Heart transplants

The treatment your child receives depends on the type and severity of the defect. Other factors include your child's age, size, and general health. Treatment can be simple or very complex. Many children are treated with medicines and are monitored by their doctor. Other children may need surgery.

Medicines

Your child may take one or more of the following medicines to help the heart work better and lessen symptoms:

• Digoxin is thought to improve heart function and can keep the heartbeat regular.
• Diuretics treat the buildup of fluid in the heart and body.
• ACE inhibitors decrease the work the heart has to do and may help remodel the heart and blood vessels to work more efficiently.
• Beta blockers slow the heart rate and lower blood pressure to decrease the workload on the heart.
• Inotropes strengthen the heart's pumping ability.
• Prostaglandin E1 is used to keep the ductus arteriosus open in some defects until corrective surgery can be performed. This improves blood flow and oxygen levels until the defect is corrected. The ductus arteriosus normally closes within a few days after birth.

Special Procedures Using Catheters

Doctors can correct some congenital heart defects during cardiac catheterization. These are called catheter-based procedures or interventions. They can be used instead of open-heart surgery, which is a major operation. A catheter is inserted through a blood vessel in your child's groin. It is then threaded to the heart, where some holes in the interior walls of the heart can be fixed, a patent ductus arteriosus can be closed, and narrow valves and blood vessels can be opened up. Cardiac catheterization:

• Does not require your child's chest to be opened
• Lets your child recover quickly
• Has different risks than open-heart surgery

Surgery

Your child may need open-heart surgery if the defect can’t be repaired using a catheter-based procedure. Some surgeries repair the defect completely. Other surgeries improve the child's health but do not completely repair the defect. Open-heart surgery may be done to:

• Close holes with stitches or with a patch
• Repair valves
• Widen arteries or openings to valves
• Put the great vessels (aorta and pulmonary artery) in their correct positions

Sometimes, open-heart surgery can improve a child's health but not repair the problem. Examples include:

• Decreasing blood flow to the lungs by placing a band around the pulmonary artery
• Increasing blood flow to the lungs by connecting an artery from the aorta to the pulmonary artery
• Connecting the veins that bring oxygen-poor blood directly to the pulmonary artery in a three-stage surgery when the right ventricle is not developed (for example, hypoplastic left heart syndrome)

Heart Transplants

Babies born with multiple defects that are too complex to repair may need a heart transplant. In this procedure, the child's heart is replaced with a healthy heart that has been donated.

Reference:

National Heart, Lung, and Blood Institute, USA.