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Endocardial cushion defect - Treatment

Alternative Names

Atrioventricular (AV) canal defect; Atrioventricular septal defect; AVSD

Treatment:

Surgery is needed to close the holes between the heart chambers, and to separate the common valve into distinct tricuspid and mitral valves. The timing of the surgery depends on the child's condition and the severity of the ECD. It can usually be done when the baby is 3 - 6 months old. Correcting an ECD may require more than one surgery.

Your doctor may prescribe medication before surgery if the ECD has made your baby very sick. The medicines will help the child gain weight and strength before surgery. Medications may include:

  • Diuretics (water pills)
  • Drugs that make the heart contract more forcefully (inotropic agents), such as digoxin

Surgery for a complete ECD should be done as early in the baby's first year of life as possible, before irreversible lung damage occurs. Babies with Down syndrome tend to develop lung disease earlier, and therefore early surgery is very important for these babies.

See also:

Expectations (prognosis):

How well your baby does depends on the severity of the ECD, the child's overall health, and whether lung disease has already developed. Many children live normal, active lives after the ECD is corrected.

Complications:

Complications from ECD may include:

  • Congestive heart failure
  • Death
  • Eisenmenger syndrome
  • High blood pressure in the lungs
  • Irreversible damage to the lungs

Certain complications of ECD surgery may not appear until the child is an adult. These include heart rhythm problems and a leaky mitral valve.

Children with congenital heart disease may need to take antibiotics before dental treatment. This helps prevent complications related to heart infections. Ask a cardiologist whether your child needs to take antibiotics.

Calling your health care provider:

Call your health care provider if your child seems to tire easily, has trouble breathing, or has bluish skin or lips. You should also consult your health care provider if your baby is not growing or gaining weight.
  • Reviewed last on: 4/30/2010
  • Kurt R. Schumacher, MD, Pediatric Cardiology, University of Michigan Congenital Heart Center, Ann Arbor, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Park MK. Pediatric Cardiology for Practitioners, 5th ed. Philadelphia, Pa: Mosby Elsevier; 2008:181-189:chap 12.

Townsend Jr. CM, Beauchamp RD, Evers BM, et al. Sabiston Textbook of Surgery, 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:1760-1762.

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