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A congenital heart defect is an abnormal heart from birth. Approximately eight out of every 1,000 infants are born with congenital heart disease. Some defects are mild and may not even be noticeable during infancy or childhood. Others are life-threatening and need surgery during infancy.
At the University of Vermont Medical Center, our cardiologists work with patients of all ages to evaluate and treat congenital heart disease.
Congenital Heart Disease Care at UVM Medical Center
The care of infants and children with congenital heart disease has been a monumental success, with over 90 percent of infants born with congenital heart disease now living well into adulthood. However, since these people's hearts are not normal even though they are repaired, they need doctors who specialize in treating adults with congenital heart disease.
Common Congenital Heart Defects in Adults
There are many different types of congenital heart disease. Several of the most common include:
- Atrial Septal Defect (ASD) - An ASD is a hole between the heart's two upper chambers. It is one of the most common types of congenital heart defects. ASDs are present from birth, although symptoms usually do not appear until adulthood. Smaller defects require no treatment. Larger defects can cause serious damage to the heart and lungs and lead to serious conditions, including heart failure and heart rhythm disorders.
- Ventricular Septal Defect (VSD) - A VSD is a hole between the heart's lower two chambers. Most VSDs are present from birth. Some VSDs occur as a complication of a heart attack. Not all VSDs require treatment. Larger defects can cause serious damage to the heart and lungs and lead to serious conditions such as congestive heart failure.
- Patent Ductus Arteriosus (PDA) - A PDA is the persistence of the passage between the aorta and the pulmonary artery, and is a normal structure in the fetus. After birth, this structure usually closes in most people. A small number of people reach adulthood before the discovery of a PDA.
Not all PDAs require treatment. Larger defects can cause serious damage to the heart and lungs and lead to serious conditions such as heart failure and heart rhythm disorders.
- Patent Foramen Ovale (PFO) - A PFO is the persistence of the small passage between the heart's upper two chambers that is a normal structure prior to birth. It is very common - up to 1 in 4 people have a PFO. Unlike ASDs, a PFO is usually too small to lead to heart failure or heart rhythm disorders. However, PFO may be associated with a future risk of stroke in those who have had a stroke. Closure of PFO may reduce the risk of future stroke in some patients. There are other rare medical circumstances where closure of PFO may be of benefit.
Congenital Heart Defects Diagnosis
A congenital heart defect may be initially detected as abnormal heart sounds heard by your primary care physician through a stethoscope. Additionally, other findings from a physical exam, chest x-ray, or electrocardiograms can lead to the discovery of congenital heart disease.
Imaging studies can help confirm the congenital heart disease diagnosis. Our cardiac imaging experts offer a wide range of tests to diagnose your condition and are specially trained in the latest technology and techniques. The process of diagnosis may involve the following:
- Physical examination - A cardiologist specializing in congenital heart disease will listen to your heart and lungs and conduct a thorough examination.
- Echocardiogram - This test evaluates the structure and function of the heart. It uses sound waves to produce an image of your heart in motion. An echocardiogram is a valuable tool for diagnosing atrial septal defect, as it can:
- Show whether other heart problems exist
- Show the pattern and amount of blood flow through the defect
- Determine the location, type, and size of the congenital heart defect
- Help determine the best options to treat the defect, including catheter-based devices or open chest surgery
- Electrocardiogram - This test, also called an EKG or ECG, records the electrical activity of your heart through electrodes attached to your skin. An ECG indicates any abnormal rhythms and stress to the heart.
- Computed Tomography and Magnetic Resonance Imaging - These tests use x-ray radiation and magnetic resonance, respectively, to evaluate the structure and function of the heart. In addition, these tests can also image many of the other organs in the chest cavity, including the blood vessels. Many congenital heart defects are associated with other congenital defects in organs and the blood vessels, and cardiac CT or cardiac MR may be the best way to evaluate these.
- Cardiac catheterization - Experts in The UVM Medical Center's Cardiovascular Catheterization Laboratories can make pressure and blood flow measurements with catheters inside your heart. Additionally, they can inject a dye into the arteries of your heart through a catheter. The dye is visible on x-ray and video, helping to identify any blocked or narrowed arteries. This test gives valuable information about the structures inside the heart and helps determine the best method to treat your congenital heart defect.
Congenital Heart Defects Treatments
Many adults think that if their congenital heart disease was treated when they were a child or an infant, they are cured. However, lifelong follow-up care is important.
Having congenital heart disease does not mean that you will experience lifelong heart problems. It simply means that you are more at risk for certain complications. Or perhaps you didn't need treatment before, and now your congenital heart defect requires corrective therapy.
As one of the leading cardiology programs in the region, The University of Vermont Medical Center offers a broad range of treatments for atrial septal defect and other congenital heart defects. Patients have access to leading-edge technology and the latest therapies available.
You have the benefit of working with highly trained and experienced non-invasive congenital heart experts, interventional cardiologists, as well as consultation with cardiac surgeons, who are on the frontiers of developments in cardiac medicine.
Treatment options for congenital heart disease at The UVM Medical Center include both non-surgical and surgical treatments.
The adult congenital heart disease clinic at our Tilley Drive, South Burlington, Vermont location will have experts that direct the non-invasive care of your heart disease. These non-invasive approaches and therapies include:
- Observation - If you have a small defect with no symptoms, you may only need routine monitoring by a cardiologist. Periodic check-ups may include the following:
- Physical exam - A cardiologist will listen to your heart and lungs.
- Electrocardiogram - A test using electrodes on your skin will record the electrical activity of your heart.
- Chest x-ray - A radiologist will take an image of the internal structures of the chest, including the heart.
- Echocardiogram - A test using sound waves will create a picture of your heart in motion.
- Exercise test - A test will check for changes in your heart while you exercise on a treadmill or stationary bike.
- Medication - While medications cannot correct your congenital heart defect, they may be used to relieve some of the symptoms. For large defects, medications do not affect the long-term risks of heart failure or heart rhythm disorders.
Surgical and Catheter-Based Treatments
The UVM Medical Center is the only cardiac surgery program in the state of Vermont. Our interventional cardiologists and cardiac surgeons provide the latest treatments and therapies to repair your congenital heart defect and restore normal blood flow.
With this procedure, a cardiac surgeon inserts a catheter into a blood vessel in the groin and guides it to the heart. The procedure is performed using guidance from x-ray and ultrasound. Using the catheter, the surgeon inserts a metal and fabric device to close the hole. Heart tissue eventually grows into and around the device, sealing the defect.
Not all atrial septal defects can be closed with this technique and thus your doctor will work closely with our non-invasive cardiology/imaging experts as well as our cardiac surgery team to recommend the best therapy.
Some patients with congenital heart defects may require open-heart surgery. An experienced cardiac surgeon opens the chest cavity to gain access to the heart and works directly with the muscle and valves.
Congenital Heart Disease at UVM Medical Center: How We Compare
The UVM Medical Center’s interventional cardiologists perform almost 5,000 catheter-based procedures every year, including procedures to help pediatric and adult patients with congenital heart disease. We are the only hospital in Vermont that provides patients this alternative to open heart surgery.
We also provide cardiac expertise that you will only find at advanced-level care centers like UVM Medical Center. Our doctors specialize in performing cardiac procedures such as coronary angioplasty and stenting, coronary artery bypass surgery and congenital heart defect correction.