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Thursday, December 6, 2007

Treatment of Congenital Heart Defects

How Congenital Heart Defects Treated?

Doctors treat congenital heart defects with:· Medicines· Special procedures using catheters· Surgery· Heart transplantsThe 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.

With 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 CathetersDoctors 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.
With 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 positionsSometimes, 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)

With 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.


The prevention of Congenital Heart Defects:

There is no known way to prevent congenital heart defects, but there are things you can do to lower the chance that your baby will have a congenital heart defect. However, even after you lower the risks, your baby may still develop a congenital heart defect.If you are planning to become pregnant or are pregnant, talk to your doctor about any medicines that you are taking, including:· Over-the-counter medicines· Prescription medicines· Vitamin and mineral supplements· Herbal supplementsYour doctor will recommend that you take folate before you become pregnant. This is recommended mainly to prevent abnormalities in the baby's nervous system, and there is some evidence that it may also help prevent certain types of congenital heart defects.You should avoid:· Strong chemicals, including some cleaning products· Repeated exposure to x rays· Any harmful or poisonous materialsIf you or anyone in your family has a congenital heart defect, genetic testing may be available. It can show if there is a genetic cause for a congenital heart defect. Testing cannot prevent a congenital heart defect but it may be able to make you aware of the risks.

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