Atrioventricular Septal Defect (AVSD) Treatment

Overview of Atrioventricular Septal Defect (AVSD) Treatment in India

Atrioventricular septal defect is a combination defect located in the centre of the heart, which is referred to as a ‘congenital’ or ‘congenital heart defect’ and therefore, is present at birth. A child with this heart defect will have a hole (or defect) between some chambers of the heart and will also have problems with the valves in the heart that control the flow of blood. 

With atrioventricular septal defect, more blood flows to the lungs than would normally occur. This excess blood puts extra stress on the heart, which causes the heart muscle to hypertrophy (grow larger).

If an atrioventricular septal defect is left untreated, there is a risk of developing heart failure and/or high blood pressure in the lungs. The usual treatment option is surgery to close the defect and repair the valves; this usually occurs during the first year of life.

Other terms used to describe atrioventricular septal defect are:

Atrioventricular canal defect; endocardial cushion defect and atrioventricular septal defect (or atrioventricular canal defect).

What Is an AV Canal Defect?

An atrioventricular (AV) canal defect is a heart problem you’re born with. Basically, it means there’s a hole in the middle of your heart, plus issues with how the valves work.

Think of that hole like a leak in a pipe—it lets blood that’s loaded with oxygen mix with blood that isn’t, which shouldn’t happen in a healthy heart. Usually, this hole sends too much blood to your lungs and not enough to the rest of your body. If it sticks around long enough, the flow can actually flip, so more oxygen-poor blood starts heading out to your body instead of your lungs. That drops your oxygen levels and can turn your skin bluish (called cyanosis). On darker skin, it might look gray or pale.

Since your heart has to work overtime to keep up, AV canal defects can lead to bigger problems like congestive heart failure.

This defect can be deadly for kids without treatment. Without surgery, most children with it live only two or three years. The upside? Surgery to fix it works really well. Doctors can spot the defect in babies before it gets dangerous.

About 1 in every 1,700 babies in the U.S. is born with this, making up 3% to 5% of all heart defects in newborns.

You might also hear it called atrioventricular septal defect, AVSD, or endocardial cushion defect.

Types of Atrioventricular Septal Defect (AVSD) Treatment:

Instead of a single atrioventricular canal defect, there are a number of different shapes and sizes, depending on where you find the hole, its size, and the number of valves that you possess. Here’s how they break down:

Complete AV canal defect

In this one, there is a large opening in the middle of the heart, and it connects all four chambers. Rather than two normal valves between the top chamber and the bottom chamber, there has been only one, and frankly, it happens not to open or close properly all the time.

Partial AV canal defect

The hole, in this case, is typically located between the two upper chambers (in rare cases, it may be between the lower chambers). There are still two atrial-ventricular valves, although at least one of them is not functioning correctly.

Transitional AV canal defect 

It is a mixture of this, a hole between the upper chambers, and another between the lower ones. The two AV valves remain detached.

Unbalanced complete AV canal defect

That one AV valve is not centred in this instance. It is closer to one of the ventricles; consequently, there is more blood entering that side. The extra-blood ventricle becomes larger, and the other side remains small, which is known by the doctors as hypoplastic.

Procedure:

Babies with atrioventricular septal defects often start to feel better with medication, but in the end, heart surgery is always necessary.

Doctors usually use medicines like diuretics—Lasix (furosemide) is a common one—to help get rid of extra fluid and ease the strain on the heart. This kind of treatment helps manage symptoms, making it easier for babies to eat, grow, and get stronger. Sometimes, they need extra calories, so parents might have to fortify breast milk or formula to help with weight gain.

When it comes to surgery, the timing depends on the type of defect. For a complete atrioventricular septal defect, surgeons usually operate between 3 and 6 months old. For a partial defect, they wait a little longer—usually somewhere between 6 and 18 months.

During surgery, the team closes the holes in the heart with a patch and rebuilds the shared atrioventricular valve. Problems can pop up afterwards, especially if the valve openings end up too small or too leaky—this happens more often with the left-sided valve.

There’s another tricky part. The tissue that carries the heart’s electrical signals runs right near where surgeons have to put stitches for the patch. If that gets damaged, the baby might need a pacemaker to keep the heart beating properly.