Congenital Heart Disease

Treatment

Cardiologists and cardiovascular surgeons at Mayo Clinic in Rochester pioneered many of the standard treatments for congenital heart diseases. Specialists in Rochester treat every kind of congenital heart disorder in children and adults. Specialists in Jacksonville and Scottsdale treat certain kinds of congenital heart disease in adults.

Most congenital heart disorders can be corrected or improved with surgery. Some don't require any treatment. Either way, many people with congenital heart defects can live full and healthy lives.

For information on treatment of a specific disease, see list of diseases congenital diseases treated.

Many types of congenital heart disease can cause major problems starting immediately or soon after birth. Some of them may even lead to irreversible changes that might prevent surgical correction later in life. Therefore, the trend is to operate on children with congenital heart disease at earlier ages. Most operations can fix the problem, but continuing medical care generally is needed following the procedure. Heart rhythm disorders and endocarditis remain potential threats, even years later.

Some operations are palliative, meaning the problem is not fixed, but adjustments are made to let the circulation work as well as possible under the circumstances. Palliation is done at a young age to allow the heart and circulation to develop enough so a reparative operation can be done later. Sometimes a palliative operation is all that can be done.

Congenital heart defects can be so severe that life cannot be maintained, or they can be so mild that trouble is not even suspected. Sometimes these abnormalities never do cause problems. Other times they become more abnormal with aging and then cause problems. For example, a child with a bicuspid aortic valve may have satisfactory function of the valve. As the child ages, the valve may thicken and calcify and lead to narrowing (stenosis), or it may retract and result in backward leakage (regurgitation). These changes may not produce symptoms until middle age or even later.

Many congenital heart defects can be surgically repaired at a young age. Sometimes the doctor may recommend waiting for a time before repairing a defect. Reasons for this delay include the following:

• The problem will not get any worse if you wait for a limited time.
• The operation will be easier on the baby at an older age.

Some congenital problems are very hard to diagnose without difficult, risky and expensive tests, which are done only if there is a high suspicion of an abnormality. If the defect is not causing obvious problems, the likelihood increases that it might be overlooked at routine examinations.

With some congenital defects, such as ventricular septal defect, if an operation to close the defect is postponed too long, the damage can be so severe that an operation to correct the problems is no longer helpful because of the high lung (pulmonary) artery pressure.

Heart Transplant

When needed, Mayo Clinic also offers an experienced heart transplant program. Mayo surgeons have performed 40 heart transplants on children and adolescents since 1990 and have an 86 percent five-year survival rate, according to the United Network for Organ Sharing.