Congenital heart defect corrective surgeries

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		Heart, front view
Ultrasound, normal fetus - heartbeat	Ultrasound, normal fetus - heartbeat

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Ventricular septal defect (VSD) repair

• The ventricular septum is the wall between the left and right ventricles (lower chambers) of the heart. A hole in the ventricular septum is called a VSD.
• By age 1, most small VSDs close on their own. However, those VSDs that do stay open after this age must be closed.
• Larger VSDs, small ones in certain parts of the ventricular septum, or ones that cause heart failure or endocarditis (inflammation) need open-heart surgery. The hole in the septum is usually closed with a patch.
• Some septal defects can be closed using heart catheterization. This procedure involves passing a small wire into the heart and placing a patch over the defect. It is guided by x-rays.

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Tetralogy of Fallot repair

• Tetralogy of Fallot is a heart defect that exists from birth (congenital). It usually includes four defects in the heart and causes the baby to turn a bluish color (cyanosis).
• Open-heart surgery is needed, and it is often done when the child is between 6 months and 2 years old.
• Different types of repairs are done, depending on the defects.
  • The ventricular septal defect is one repair, and it is described above.
  • The pulmonary valve is opened and the thickened muscle (stenosis) is removed.
  • A patch may be placed on the right ventricle and main pulmonary artery to improve blood flow to the lungs.
• The child may have a shunt procedure done first. A shunt moves blood from one area to another. This is done if the open-heart surgery needs to be delayed because the child is too sick to go through surgery.
  • A shunt procedure requires making a cut between two of the ribs.
  • Once the child is older, the shunt is closed and the main repair in the heart is performed.

Transposition of the great vessels repair

• In a normal heart, the aorta comes from the left side of the heart, and the pulmonary artery comes from the right side. In transposition of the great vessels, these arteries come from the opposite sides of the heart.
• Correcting transposition of the great vessels requires open-heart surgery. If possible, this surgery is done shortly after birth.
• The most common repair is called an arterial switch. The aorta and pulmonary artery are divided. The pulmonary artery is connected to the right ventricle, where it belongs. Then, the aorta and coronary arteries are connected to the left ventricle, where they belong.