Heart defects are common birth defects that can affect different parts of the heart, including the valves, septum, and ventricles. Some defects require immediate surgery, while others may heal on their own. With advancements in treatment, many children with heart defects can live normal, healthy lives.
Heart defects remain some of the most common birth defects. Not all are expressed directly at birth, and some are so mild that they don’t need treatment right away, or they may heal on their own and never require treatment. Others are severe and will need emergency surgery, but with this surgery, many children are able to live normal, healthy lives and have an excellent life expectancy.
The types of heart defects are often grouped according to the part of the heart they affect. These include defects of the heart valves, the septum, the internal valves of the heart or the ventricles. Other types of heart defects combine several defects at once or have to do with how the heart was formed when it was formed.
Valve defects can mostly refer to defects in the aortic and pulmonic valves, which are the large arteries that branch off from the heart’s two lower chambers, called the ventricles. Sometimes the valves are transposed (transposition of the great arteries or TGA) and this requires repair immediately after the baby is born. Babies with this condition are often cyanotic (blue) and will die shortly after birth if they don’t get surgical repair. Other times one or both arteries are narrowed (stenotic) which can prevent blood from flowing properly from the heart. This can cause extra pressure on the heart and heart failure. The narrowing can be mild or very severe, and occasionally a valve is almost completely absent or closed (atresia).
Septal defects refer to problems with the wall separating the right and left chambers. Often the septum has failed to close completely which can result in small holes and communication between the right and left side. When these holes are present in the lower two chambers they are called ventricular septal defects (VSD) and when they are present in the upper two chambers they are called atrial septal defects (ASD). The holes can be so small that very little blood leaks back and forth between the atria or ventricles, but they can also be large or multiple and require repair to close the connection.
Sometimes the valves in the heart that separate the lower and upper chambers don’t form properly. Conditions such as tricuspid atresia may require immediate medical attention. Some people have minor defects in the mitral valve (left side) that aren’t noticed until they’re in their teens or older. Surgical repair may be needed to treat the mitral valve later.
Heart defects in the ventricles can also occur and these can be some of the more difficult conditions to treat. These important pumping chambers may be too small or hypoplastic and require several surgeries to relieve the condition. It is also possible to have a mixed group of defects that may require significant intervention. It is by no means impossible for a child to be born with a ventricular septal defect, a hypoplastic ventricle, and a stenotic valve or transposition of the valves.
Some defects are very unusual and cause the heart to spin the wrong way when it is forming. In dextrocardia, the heart is located on the right side of the chest and in mirror image forms, all organs are a mirror image of the average human body. Under certain conditions, dextrocardia presents with the absence of a spleen or multiple spleens, and the heart can have several congenital anomalies as well as having a wrong cycle.
It helps to realize that despite the severity of defects that may exist in the heart, there are excellent specialists who can treat these conditions and surgery and the outlook continues to improve for those many congenital heart defects. A number of conditions that were once thought to be irreparable are now being repaired on a regular basis, and the most aggressive potential repair to a badly damaged heart, transplantation, continues to improve survival rates as well.
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