|
Condition name and description
|
Typical diagnosis / treatment
|
|
Anomalous pulmonary venous connection (APVC)|:| all veins from the lungs are connected to the right (instead of the left) collecting chamber (atrium) of the heart.
|
This is usually diagnosed by echocardiogram| and occasionally MRI|. The type of abnormal connection (partial or total), determines whether surgery| needs to be carried out urgently or not. An interventional approach is only carried out as a rescue treatment.
|
|
Aortic stenosis|: The valve connecting the left pumping chamber of the heart and the main artery that goes to the body is too narrow.
|
This is typically diagnosed by echocardiography| and treated with interventional cardiac catheterisation. Depending on the severity and the presence of other heart conditions, surgery| might be necessary.
|
|
Atrial septal defect (ASD):| this is a connection (hole) between both collecting chambers (atria) of the heart.
|
Diagnosis is usually by transthoracic, and occasionally, transoesophageal echocardiography|. ASDs are commonly treated using cardiac catheterisation|, but depending on the size and location of the defect, surgery| may be necessary.
|
|
Coarctation (CoA) of the aorta:| the main body artery narrows, which means the blood supply to the lower half of the body is impaired.
|
Diagnosis and treatment for babies is based on clinical findings (such as weak pulses in the legs) and echocardiography|. Typically treatment is surgery|, but occasionally cardiac catheterisation| may be the treatment of choice.
In older children, diagnosis is based on clinical findings (such as weak pulses in the legs and high blood pressure), echocardiography| and MRI|. Treatment depends on the type of lesion. Surgery| may be recommended, but in teenagers and adults, interventional cardiac catheterisation| is usually the preferred treatment.
|
|
Complete atrio-ventricular septal defect (AVSD):| instead of two valves connecting the two collecting chambers (atria) with the two pumping chambers (ventricles), there is only one common valve connecting all four chambers of the heart.
|
Diagnosis is usually established by echocardiography| and ECG (electrocardiogram). This heart condition is treated surgically. The timing of surgery| is dependant on the size of the defect (hole) and how well the cardiac valves are working.
|
|
Partial atrio-ventricular septal defect (AVSD): |
similar to complete AVSD outlined above.
|
From the hemodynamics (bloodflow), this defect is very much the same as an ASD|. However, as with the complete AVSD, the standard approach is surgery|.
|
|
Hypoplastic left heart syndrome (HLHS):| the left pumping chamber is underdeveloped.
|
This very complex heart condition has been treated at the Evelina since 1992. Treatment usually involves 3 operations:
-
carried out in the neonatal period
-
in the first year of life
-
between the ages of 2 and 5
Since 2005, some patients have been able to have a combined surgical and interventional approach, avoiding cardiopulmonary bypass (hybrid operation).
|
|
Persistent ductus arteriosus (PDA):| an arterial duct between the main blood vessels of the heart is present during pregnancy. This should close during birth.
|
Specialised devices now enable this to be closed in most patients. Pre-term babies still need surgery|.
|
|
Pulmonary atresia with an intact ventricular septum:| the valve connecting the right pumping chamber of the heart (right ventricle) and the main artery to the lungs (pulmonary artery) does not open. The right ventricle can be underdeveloped.
|
Depending on the size of the right ventricle, it may be possible to open the blockage with a balloon and insert a stent at the arterial duct. If the right ventricle grows well enough, surgery| may not be necessary.
|
|
Pulmonary atresia with ventricular septal defect:| the valve connecting the right pumping chamber of the heart (right ventricle) and the main artery to the lungs (pulmonary artery) does not open.
|
Treatment depends on the size of the ventricles and the vessels connected to the heart. In most cases this involves surgery|.
|
|
Pulmonary stenosis (PS):| the valve connecting the right pumping chamber of the heart (right ventricle) and the main artery to the lungs (pulmonary artery) is narrow.
|
In most cases, a heart murmur leads to further investigation. Diagnosis is by echocardiography|. Usually, treatment involves heart catheterisation to open the narrow valve with a balloon.
|
|
Tetralogy of Fallot (ToF):|
the septum between both pumping chambers (ventricles) is not developed, leading to a narrowing of the outflow part of the right pumping chamber (ventricle), a ventricular septal defect with overriding of the aortic valve.
|
Depending on the size of the child, surgery| involves one or two steps. In some cases an artificial vessel (called a BT-shunt), is needed first to provide enough bloodflow into the lungs to allow the arteries to grow. Later, corrective surgery is carried out. In most cases the shunt is not necessary.
|
|
Transposition of the great arteries:| the main body artery (aorta) and the main lung artery (pulmonary artery) are both connected to the wrong pumping chamber (ventricle).
|
Diagnosis is by echocardiography| and treatment is usually within the first few days of life.
|
|
Complex transposition of the great arteries:| as above, but with complications.
|
In most cases echocardiography| can show all the anatomical details, but occasionally an MRI| is needed to investigate the heart in even more detail. Treatment depends on the exact defect.
|
|
Congenitally corrected transposition of the great arteries:| the main body artery (aorta) and the main lung artery (pulmonary artery) are both connected to the wrong pumping chamber (ventricle). The collecting chambers are wrongly connected as well.
|
Depending on the presence of additional congenital heart disease, treatment is timed.
|
|
Tricuspid atresia:| the valve connecting the right collecting chamber (atrium) and the right pumping chamber (ventricle) does not open.
|
Treatment consists of staged surgery|.
|
|
Ebstein's Anomaly:| the valve connecting the collecting chamber (atrium) and the right pumping chamber (ventricle) (the tricuspid valve) is displaced towards the tip of the heart.
|
Depending on the degree of valvar displacement, surgery| may be necessary. The frequent rhythm disturbances need to be followed.
|
|
Truncus arteriosus (single arterial trunk):| instead of the main body artery (aorta) and the main lung artery (pulmonary artery) there is only one vessel arising from both ventricles.
|
Treatment is usually surgery.|
|
|
Ventricular septal defect (VSD) large:| this is a large hole between both pumping chambers (ventricles).
|
The large defects have to be closed surgically.
|
|
Ventricular septal defect (VSD) small:|
this is a hole between both pumping chambers (ventricles).
|
Depending on the location of the defect, cardiac catheterisation| may be possible, avoiding open heart surgery|.
|