• Before birth, there is a natural blood vessel between the aorta (the main artery to the body) and the pulmonary artery (the main artery to the lungs) called the ductus arteriosus. This opening usually closes shortly after birth. A PDA occurs when this opening fails to close after birth.
• Sometimes the PDA can be closed with a procedure that does not involve surgery. The procedure is usually done in a laboratory that uses x-rays. In this procedure, the surgeon inserts a few small tubes into an artery in the leg and passes them up to the heart. There are no cuts, except for a tiny hole in the groin. Then, a small metal coil or another device is put into the child's arteriosus artery. The coil or other device blocks the blood flow, and this corrects the problem.
• Another method is to make a small surgical cut on the left side of the chest. The surgeon finds the PDA and either ties off the ductus arteriosus, or divides and cuts it. Tying off the ductus arteriosus is called ligation. This procedure may be done in the neonatal intensive care unit (NICU).

Coarctation of the aorta repair

• Coarctation of the aorta occurs when a part of the aorta has a very narrow section, like in an hourglass timer.
• To repair this defect, a cut is usually made on the left side of the chest, between the ribs. There are many ways to repair coarctation of the aorta.
• The most common way to repair this is to cut the narrow section and make it bigger with a patch made of Gore-tex, a man-made (synthetic) material.
• Another way to repair this problem is to remove the narrow section of the aorta and stitch the remaining ends together. This can usually be done in older children.
• A third way to repair this problem is called a subclavian flap. First, a cut is made in the narrow part of the aorta. Then, a patch is taken from the left subclavian artery (the artery to the arm) to enlarge the narrow section of the aorta.
• A fourth way to repair the problem is to connect a tube to the normal sections of the aorta, on either side of the narrow section. Blood flows through the tube and bypasses the narrow section.
• A newer method does not require surgery. A small wire is placed through an artery in the groin and up to the aorta. A small balloon is then opened up in the narrow area. A stent or small tube is left there to help keep the artery open. The procedure is done in a laboratory with x-rays.

Atrial septal defect (ASD) repair

• The atrial septum is the wall between the left and right atria (upper chambers) of the heart. There is a natural opening before birth that usually closes on its own when a baby is born. When the flap does not close, the child has an ASD.
• Sometimes ASDs can be closed without open-heart surgery. First, the surgeon makes a tiny cut in the groin. Then the surgeon inserts tubes into a blood vessel that go into the heart. Next, two small umbrella-shaped "clamshell" devices are placed on the right and left sides of the septum. These two devices are attached to each other. This closes the hole in the heart. Not all medical centers do this procedure.
• Open-heart surgery may also be done to repair ASD. Using open-heart surgery, the septum can be closed using stitches. Another way to cover the hole is with a patch.

Ventricular septal defect (VSD) repair

• The ventricular septum is the wall between the left and right ventricles (lower chambers) of the heart. A hole in the ventricular septum is called a VSD.
• By age 1, most small VSDs close on their own. However, those VSDs that do stay open after this age must be closed.
• Larger VSDs, small ones in certain parts of the ventricular septum, or ones that cause heart failure or endocarditis (inflammation) need open-heart surgery. The hole in the septum is usually closed with a patch.
• Some septal defects can be closed using heart catheterization. This procedure involves passing a small wire into the heart and placing a patch over the defect. It is guided by x-rays.

Images

Ultrasound, normal fetus - heartbeat

Heart, front view

Ultrasound, normal fetus - heartbeat

• < Page
1 2 3 4 5
• >

Next Section

Congenital heart defect corrective surgeries Risks

Review Date: 11/01/2010
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)