Congenital Heart Disease

The causes for Congenital Heart Disease are not very well known, though they may include:

• Chromosomal or genetic conditions, which can be inherited or might occur once in a while during early pregnancy:
  1. Down Syndrome, DiGeorge Syndrome, Marfan Syndrome and Turner Syndrome
• Environmental factors can lead to congenital heart disease:
  1. Excessive drug or alcohol consumption during pregnancy, acne medications, exposure to chemicals, viral infections (e.g. rubella), and other diseases including diabetes

Many congenital heart defects result in no symptoms. When the heart defects are severe or if multiple heart defects are present, especially in newborns, the following symptoms occur:

• Blue skin, lips and fingernails
• Chest pain
• Fainting
• Heart murmur
• Palpitation
• Poor blood circulation
• Rapid breathing
• Tiredness

Transcatheter Procedures may be used. These are minimally invasive procedures that are commonly performed using a catheter (small tube). This includes the delivery of an intravascular device such as a balloon, a coil or a stent to help dilate or close (device closure) existing cardiovascular defects.

Types of transcatheter procedures include:

• Balloon Angioplasty or Balloon Dilation is a procedure that allows the expansion of narrowed blood vessels to improve blood flow within the heart.
• Balloon Atrial Septostomy, which is used to treat some congenital heart defects and can be performed in foetuses or infants. It is usually a technique that expands the hole between the right and left side of the heart.
• Balloon Valvuloplasty, which is recommended for patients whose valves are narrowed. A tiny balloon catheter is directed to the target valve, which is inflated and deflated several times, until the valve opening is widened sufficiently.
• Device closure of a condition called Patent Ductus Arteriosus (PDA) is performed when a baby’s Ductus Arteriosus (artery normally present in all foetuses) is not completely closed after birth. A device is inserted through the blood vessels in the groin to close this gap.
• Device closure of Atrial Septic Defect (ASD), a congenital heart defect between the upper two chambers of the heart. Device closure is done whereby an occluder (separator) is inserted to divide the two chambers so the heart can resume its normal function.

Surgery

• Cavo-pulmonary shunt (CPS)
• Fontan procedure
• Ligation of patent ductus arteriosus
• Modified blalock taussig shunt (BTS)
• Norwood procedure
• Pulmonary artery band (PAB)
• Rastelli operation
• Ross procedure

• Complications related to pregnancies, use of contraception and risk to offspring
• Inflammation of the inner layers of the heart (Endocarditis)
• Managing of resulting non-cardiac medical problems
• Social, emotional, financial, employment and educational issues
• Surgical procedure complication and life-long follow-up