Adult Congenital Heart Disease
What is Adult Congenital Heart Disease?
Congenital heart disease is a type of defect in one or more structures of the heart or blood vessels that occur before birth. The most common congenital heart disorders affecting adults include abnormalities of the valves and vessels of the heart wall that develop with wear and tear on the heart, or through other disease processes. The most common types of congenital heart disease include abnormal connections between the right and left sides of the heart, such as holes in the walls, or obstructions in the normal pathways exiting the heart.
Symptoms of Adult Congenital Heart Disease
Many such patients can lead normal childhoods, but begin to develop symptoms as adults. Non-surgical repairs are available for many of this simpler heart defects, and are discussed below. Rarer types of congenital heart disease include the underdevelopment or absence of normal heart structures such as cardiac chambers and valves. Connections between the heart and lungs, and the heart and the body can also be abnormal. Congenital heart defects may be diagnosed before birth, right after birth, during childhood or not until adulthood. It is possible to have a defect and no symptoms at all. In adults, if symptoms of congenital heart disease are present, they may include:
- Shortness of breath
- Poor exercise tolerance
Treatments for Adult Congenital Heart Disease
Atrial Septal Defect (ASD)
An ASD is a hole in the wall (the septum) which separates the top two chambers of the heart. A tiny self-expanding patch, resembling two small umbrellas connected to one another is implanted into the defect of the wall through a small tube (catheter), advanced from the vein in the leg.
Coarctation of the Aorta
Coarctation of the Aorta is a birth defect of the major cardiac artery (aorta) which carries the blood from the heart, to every other part of the body to supply oxygen and other nutrients. As an alternative to surgical repair, some people with coarctation of the aorta may be candidates for a cardiac catheterization procedure which involves passing a balloon and a device called a stent, into the area of the narrowing, which can be inflated to expand the narrowed area and keep it open.
Patent Foramen Ovale (PFO)
A PFO is similar to an atrial septal defect. It is a flap-like communication in the dividing wall, which allows abnormal flow between the upper two chambers of the heart. Unlike an atrial septal defect, every baby is born with this flap which is a critical part of the fetal circulation. In ~80% of all people, the two pieces of the flap fuse completely together forming a solid wall after birth. A double umbrella device can be passed to the heart through a small tube introduced at the leg, just as with repair of the atrial septal defect (above).