“My son is 8 years old and has been detected with a hole in the heart. Is surgery the only option?”
My son is 8 years old and through a mild infection, the doctors detected that he has a hole in the heart. The doctors have been reassuring us that a surgery which has a high success rate will be performed to correct this disorder. But as parents we are extremely worried. Is it the only option? Are there any risks involved?
8 Answers
CardiothoracicSurgeonCardiology
There are always risks
A hole in the heart requiring surgery is most commonly known as an ASD or VSD (Atrial septal defect or ventricular septal defect). A VSD is most often detected in the first few years of life. Indications for repair of an ASD depend on size, the degree of shunt (blood flow moving from the left to the right side of the heart) and symptoms. If your child is now 8 before it has been diagnosed, the shunt may have not caused severe symptoms. An untreated ASD can continue to place stress on the right side of the heart.
There are new techniques that are percutaneous to place a device to close the hole but they are only used for small ASDs and there is a possibility of a persistent residual hole. If the ASD is large, surgery is the best option to permanently close the hold with few complications. Discussion with an experienced pediatric cardiologist is important to determine how big and the what timing of intervention is needed for your child.
There are new techniques that are percutaneous to place a device to close the hole but they are only used for small ASDs and there is a possibility of a persistent residual hole. If the ASD is large, surgery is the best option to permanently close the hold with few complications. Discussion with an experienced pediatric cardiologist is important to determine how big and the what timing of intervention is needed for your child.
Although it sounds very scary to hear that your child may have a problem, congenital heart defects are common and are frequently easily correctable. If the hole hasn’t closed on it’s own by a certain age, the recommendations usually are to close the hole to prevent complications and avoid delays in growth and development. Depending on the location and size of the ‘hole’, it may be correctable with catheter based technology by a pediatric interventional cardiologist, or may require surgery. You certainly should have your child seen and evaluated by a pediatric cardiologist, even if that entails travel to a major medical center, who can better explain the problem and options forward therapy.
Not sure where the hole in the heart is (atrial septum or ventricular septum). Either way, if surgery is needed, it is very safe and effective (complications are not very common unless your son is very sick or has problems with elevated pressures in the heart or heart failure). You should consult with a interventional pediatric cardiologist to see if there is a possible option of closing the hole with a device and not having open heart surgery.
Juan P. Montoya
Cardiothoracic Surgeon
For children, usually surgery is the only option. I am not a pediatric cardiac surgeon, so there may be other options that I don't know of. In adults, there are options such as plugs for those holes, but children are a bit more complicated. Hope this helps.
It depends upon the size of defect and location. His pediatric cardiologist and cardiac surgeon should be able to better answer to this question after a complete evaluation. Thanks
This is a difficult question to answer because a lack of information. There are several possibilities for "a hole in the heart" and closures are different. Possible holes are ventricular septal defect (VSD), atrial septal defect (ASD) of which are two: premum and secundum ASDs. There is also another atrial septal defect call failed foramen ovale closure. The best answer comes after knowledge of the type of heart hole.
There’s always risks with any surgery, but perhaps the hole can be closed non-invasively in the cardiac cath lab.
