Congenital heart defects can sometimes go unnoticed until adulthood. Once detected, these defects may require surgery to avoid serious cardiac problems.
ATRIAL SEPTAL DEFECT REPAIR
An atrial septal defect is a hole in the wall between the upper left and right chambers (atria) of the heart. They are frequently described as heart murmurs. Atrial septal defects can go undetected until adulthood and adults with these defects often may experience other cardiac problems.
If the hole is large, oxygen-rich blood from the left atrium flows back into the right atrium and blood gets pumped back to the lungs which causes the heart to work harder and may result in serious cardiac problems. Smaller atrial septal holes are sometimes associated with stroke or transient ischemic attacks (TIAs or "mini strokes"). Small holes resolve over time on their own whereas larger holes generally require surgical intervention.
Repair of septal defects using minimally invasive surgery employs endovascular catheters (inserted via blood vessels in the groin) to patch the defect. In some cases, robotically-assisted or minimally invasive surgery may also be used to repair atrial septal defects.
In atrial septal repair surgery, a small piece of pericardial tissue (the pericardium is the thin sac that surrounds the heart) is surgically removed and used to patch the hole between the right and left atria.
VENTRICULAR SEPTAL DEFECT REPAIR
A ventricular septal defect is a hole in the wall between the lower left and right chambers (ventricles) of the heart. Ventricular septal defects are frequently detected at birth and often described as heart murmurs. However, ventricular septal defects can go undetected until adulthood and adults with these defects often have other cardiac problems.
If the hole is large, oxygen-rich blood from the left ventricle flows back into the right ventricle and blood gets pumped back to the lungs which causes the heart to work harder and may result in serious cardiac problems. Larger septal holes generally require surgery whereas smaller ones may resolve their own over time.
Ventricular septal defects can be repaired by either traditional open heart surgery or via minimally invasive surgical procedures. Minimally invasive surgery uses endovascular catheters (inserted via blood vessels in the groin) to repair ventricular septal damage.
In ventricular septal repair surgery, a small piece of pericardial tissue (the pericardium is the thin sac that surrounds the heart) is surgically removed and used to patch the hole between the right and left ventricles.
BICUSPID AORTIC VALVE REPAIR/REPLACEMENT
The aortic valve is a one-way-valve between the heart and the aorta (the main artery that distributes oxygen-rich blood to the body). Normally, the aortic valve contains three flaps or leaflets that open and close that allow blood to flow from the heart to the aorta and prevent backward flow of blood from the aorta into heart.
In bicuspid aortic valve disease, the valve has only two flaps. Because of this deformity, the bicuspid valve may start to deteriorate earlier in life. It can present as a leaky valve or as aortic stenosis. Bicuspid aortic valves are often associated with ascending aortic aneurysms. Family members of affected individuals need to be screened for the presence of a bicuspid aortic valve. When valve deterioration occurs, surgical treatment is often necessary.
Open heart surgery is required to repair or replace the valve and also a part of the aorta.
REPAIR OF ANOMALOUS PULMONARY VENOUS RETURN
Pulmonary veins are four blood vessels that bring oxygen-rich (red) blood from the lungs to the left atrium of the heart. Total or partial anomalous pulmonary venous return (TAPVR or PAPVR) is a rare heart defect in which all (total) or one or more (partial) of the pulmonary veins do not connect normally to the left atrium. Instead, the veins are re-directed to the right atrium by way of an abnormal (anomalous) connection. TAPVR usually presents in newborn children and must be surgically corrected immediately. Sometimes PAPVR can go undetected into adulthood.
The goal of surgical repair is to create an unobstructed venous inflow to the left side heart chambers. All of the surgical procedures required to correct these defects require open heart surgery.