Congenital Heart Conditions Frequently Asked Questions
At Medical City Children’s Hospital, our goal is to work one-on-one with you, always keeping you informed and answering any questions you may have. Here are some of our parents’ most-asked questions about congenital heart defects.
How common are congenital heart defects?
Congenital heart defects are more common than people think. Approximately 40,000 babies a year — nearly one out of every 100 — is born with one. However, not all heart defects require surgery. Some may resolve on their own over time, while others may be insignificant enough that surgery isn’t needed. For instance, there are some valve abnormalities or holes that exist in the heart that don’t require surgical attention.
How do congenital heart defects affect the body?
Congenital heart conditions affect the body in a multitude of ways. In the most general terms, if the heart is defective, it is not functioning at its optimal level, so other organs aren’t receiving the full benefit of its actions as they would with a normal and healthy heart.
Babies with congenital heart defects frequently fail to grow well, or thrive. This is because the two hardest things their bodies do all day is breathe and eat. A heart defect frequently results in excess blood flow to the lungs, which causes them to become congested and the baby to breathe fast, trying to get oxygen. When a baby breathes fast, it burns more calories and has less energy left over to eat. As a result, it doesn’t gain weight. However, there are medications that can help control the congestion in the lungs. This allows the baby to go home and gain weight for a few months before coming back to the hospital to undergo surgery for the heart defect.
Do children grow out of congenital heart abnormalities?
Some children can grow out of heart abnormalities, but it really depends on each child’s specific case. A fetal heart has extra blood vessels as well as holes that exist between the upper chambers of the heart. These pathways are part of the fetal circulation and normally close after birth.
When a heart abnormality is present, sometimes these extra connections in and around the heart don’t spontaneously close as they should. Some holes in both the atrial and ventricular septum may close on their own, and some valve abnormalities are not severe enough to require any intervention. However, the more major types of congenital heart defects won’t get better on their own.
Can congenital heart defects (CHD) be cured?
We’d like to think of surgery as a cure for congenital heart defects, and in many cases, it is. Sometimes tying off extra blood vessels, sewing patches inside the heart to close holes or moving arteries from an improper location to a proper location can restore the heart to a normal state or physiology. Thus the heart has been repaired and is functioning normally though it has still undergone an operation. With more complex forms of congenital heart defects, in which entire chambers of the heart are missing, surgeries won’t cure the defect but will help the heart function more normally and efficiently. With these more severe heart defects, vast improvements can be made in the heart’s physiology and efficiency but nothing can be done to create a completely normal heart when significant parts are underdeveloped or absent.
How long do repairs to congenital heart disease defects last?
How enduring the repairs to a congenital heart defect is depends on the situation. Many repairs to congenital heart defects can endure through the child’s lifetime. Babies who are born with more severe defects, such as single ventricle congenital heart disease, will require three surgeries in their first three years of life.
What is the life expectancy of a baby with a congenital heart defect?
The life expectancy of each baby with a congenital heart defect depends on that baby’s specific set of circumstances, including the type and complexity of the defect as well as any other associated birth defects or chromosomal abnormalities. Since complex open heart surgery first began in the 1950s, not enough time has passed to study someone who has lived to the age of 70 or 80 following surgery early in life. With many of the more straightforward cardiac defects, such as holes in the heart that get repaired early in life, we would expect life expectancy to approach that of a normal, healthy human being who did not have heart surgery.
We have come a long way in the treatment of most heart defects. With modern surgery tools and techniques, medicine and technology, physicians can do a great deal to help normalize the physiology of a heart so that even with severe congenital defects, children can have a good quality of life and survive for decades.
How do medications treat congenital heart disease?
While not a cure, medications can help manage the symptoms of congenital heart disease and can be used to treat babies after they are born or while they are still in the womb. Certain medications can help remove some of the lung congestion that is often present in babies with heart defects, allowing the baby’s body to function more efficiently until surgery fixes the particular condition. We can also safely treat rhythm abnormalities in utero by giving the mother medications that cross the placenta to prevent congestive heart failure in the baby.
Will my baby with a heart defect always need a feeding tube?
No, that would be extremely rare, but your baby may need the help of a feeding tube until his or her heart is repaired and functioning more efficiently. However, a feeding tube is a very unlikely long-term need.
How are congenital heart defects diagnosed?
One of the tools used for diagnosing congenital heart defects is a fetal echocardiogram, or fetal echo. This is an ultrasound — an imaging test using sound waves with no radiation exposure — like the one used for routine pregnancy exams and to find out the sex of the baby. A fetal echo focuses specifically on producing pictures of a baby’s heart while the baby is in the mother’s womb. The optimal time to perform a fetal echo is between 16 and 22 weeks into a pregnancy.
Why would my child need a heart catheterization for congenital heart defects?
A heart catheterization can provide extra information about the anatomy and physiology of a child’s heart that is helpful as the physician determines the best repair for the congenital heart defect. A heart catheterization allows the physician to see certain areas and make precise measurements that let us know if the baby is a good candidate for surgery. Additionally, there are certain heart defects that can be repaired with the use of trans-catheter techniques, thus avoiding surgery. For example, some holes in certain locations of the heart can be closed by putting a catheter through the hole and deploying a device that plugs up the hole. On the other hand, sometimes a valve that is too narrow can be widened with a balloon, done via catheterization.