Atrioventricular canal defect

Description

Atrioventricular canal defect is a mixture of problems that affect the heart center. The condition of the heart that is present at birth. That means that it is a congenital defect of the heart. Children born with this condition have a hole in the wall between the chambers of the heart. Also have problems with the valves that control the flow of blood in the heart.

Atrioventricular canal defect allows more blood to flow to the lungs. The additional blood that forces the heart to work too hard, causing the heart muscle to make it larger.

This is not, atrioventricular canal defect can cause heart failure and high blood pressure in the lungs. The treatment usually consists of surgery during the first year of life to close the hole in the heart and the repair of the valves.

Other names for this condition are:

  • Septal defect atrioventricular (AVSD)
  • Endocardial cushion defect

Symptoms

Atrioventricular canal defect may involve only the two upper chambers of the heart or of the four cameras. In both types, the excess of blood flowing into the lungs. The symptoms depend on whether the defect is partial or complete.

Complete defect

The condition affects all of the chambers of the heart. The symptoms of a complete atrioventricular canal defect usually develop in the first few weeks of life. The symptoms are generally similar to those of heart failure. They may include:

  • Blue or gray color of the skin due to low oxygen levels
  • Difficulty breathing or rapid breathing
  • Excessive sweating
  • Fatigue
  • Irregular or fast heart rate
  • Lack of appetite
  • Poor weight gain
  • Swelling in the legs, ankles and feet
  • Wheezing

Partial defect

The condition affects only the two upper chambers of the heart. The symptoms of a partial atrioventricular canal defect may not appear until early adulthood. The symptoms may be due to complications such as heart valve problems, high blood pressure in the lungs or heart failure. Symptoms may include:

  • Fatigue and weakness
  • Nausea and lack of appetite
  • Persistent cough or wheezing
  • Rapid or irregular heartbeat, also called an arrhythmia
  • Decreased ability to exercise
  • Shortness of breath
  • Swelling in the legs, ankles and feet
  • Pressure in the chest or pain

Causes

Atrioventricular canal defect occurs before birth, when the baby's heart is developing. Experts are not sure of the cause. Having Down syndrome may increase the risk.

How the heart works

To understand congenital heart defects, can be useful to know how the heart works normally.

The heart is divided into chambers. The two upper chambers are called atria. The two lower chambers are called the ventricles.

The right side of the heart moves the blood in the vessels leading to the lungs where the blood receives oxygen. The oxygen-rich blood flows into the heart from the left side and in the body's main artery, called the aorta. From there, blood flows to the rest of the body.

Valves control blood flow into and out of the chambers of the heart. These heart valves open to allow blood and close to prevent blood from flowing backwards.

What happens in the atrioventricular canal defect

In a partial atrioventricular canal defect:

  • There is a hole in the heart wall between the upper chambers.
  • There are also changes in the mitral and tricuspid valves.
  • The changes prevent the valve from closing all the way.
  • The blood can move the wrong way across the irregularity to the opening of the valve.
  • The mitral valve between the top and the bottom of the left side of the cameras most often affected.

In a complete atrioventricular canal defect:

  • There is a large hole in the center of the heart. The hole is where the walls between the upper and the lower chambers meet.
  • Oxygen-rich and oxygen-poor blood from the mixture through the hole.
  • There is a large valve between the heart of upper and lower chambers, instead of separately.
  • The blood is filtered through a large valve at the bottom of the chambers of the heart.
  • The heart must work harder to pump blood. The heart becomes larger.

Risk factors

Things that may increase the risk of atrioventricular canal defect are:

  • Genetics. Congenital heart disease appears to run in families. It is associated with many genetic syndromes. For example, children with Down syndrome often have heart problems present from birth.
  • German measles, also called rubeola. Having rubella during pregnancy can affect how the baby's heart develops while in the womb.
  • Diabetes. Poorly controlled diabetes during pregnancy can affect the baby's heart development. Gestational diabetes usually does not increase the risk of congenital heart disease.
  • The consumption of Alcohol. Drinking alcohol during pregnancy has been associated with an increased risk of heart defects in the baby.
  • The habit of smoking. If you smoke, stop smoking. Smoking during pregnancy increases the risk of congenital heart defects in the baby.
  • Some medications. Taking certain medications during pregnancy can cause heart problems and other birth defects in the baby. Always tell your doctor about all the medicines you take.

Complications

The possible complications of the atrioventricular canal defect are:

  • Enlargement of the heart. Increasing the flow of blood through the heart having to work harder than normal, causing it to become larger.
  • High blood pressure in the lungs. This condition is also called pulmonary hypertension. A hole in the heart allows the oxygen-rich blood from mixing with oxygen-poor blood. The lungs are made too much blood. The pressure builds up in the lungs.
  • Infections of the respiratory tract. A hole in the heart that can lead to lung infections.
  • Heart failure. If the atrioventricular canal defect is not treated, the heart may not pump enough blood to meet the body's needs.

The treatment significantly improves the prognosis for children with atrioventricular canal defect. But complications can occur later in life. They may include:

  • Breathing problems due to lung damage
  • The irregular rhythms of the heart
  • Leakage of the valves of the heart, also called valve regurgitation
  • The narrowing of the heart valves

Pregnancy

Those who had atrioventricular canal defect surgery before permanent damage to the lungs occurred are often capable of having a successful pregnancy. Pregnancy is not recommended if you have had severe heart or lung damage before the atrioventricular canal defect of the surgery.

Before getting pregnant, see a doctor of the heart trained in congenital heart disease about the potential risks and complications. This type of care provider is called an adult congenital cardiologist. Together, you can discuss and plan any special care needed during pregnancy.

Prevention

There is no known way to prevent the atrioventricular canal defect.

Some of the problems of the heart is transmitted in families, which means that they are inherited. If you have a personal or family history of congenital heart disease, talk with a genetic counselor and a cardiologist prior to becoming pregnant.

Atrioventricular canal defect

Diagnosis

Atrioventricular canal defect could be diagnosed in a baby before birth during an ultrasound of the pregnancy, or special images of the heart.

After birth, the symptoms of complete atrioventricular canal defect are usually visible within the first few weeks. When listening to the heart of a baby, a health care provider may hear a "whooping" sound. The sound is called a murmur in the heart.

The tests to diagnose the atrioventricular canal defect may include:

  • Pulse oximetry. A sensor that is placed at the tip of the fingers of the records of the amount of oxygen in the blood. Very little oxygen can be a sign of a heart or lung problem.
  • The electrocardiogram. Also called an ECG or EKG, this non-invasive test records the electrical activity of the heart. Adhesive patches with sensors placed on the chest. The cables connect the patches to a computer, which displays the results.
  • The echocardiogram. Use sound waves to create images of the heart in motion. An echocardiogram can reveal a hole in the heart or heart valve issues. It also shows how the blood flows through the heart.
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs. It can show whether the heart is enlarged, or if the lungs contain blood or other liquid. These could be signs of heart failure.
  • The cardiac catheterization. A thin, flexible tube called a catheter is inserted into a blood vessel in the groin up to the heart. A contrast dye is injected through the catheter makes the heart structures are shown more clearly on x-rays. During the procedure, a doctor can measure the pressure in different parts of the heart.

Treatment

Surgery is necessary to treat partial or complete atrioventricular canal defect. More than one surgery may be necessary. The surgery involves the use of one or two patches to close the hole in the wall of the heart. The patches stay in the heart. Become a part of the heart of the wall as the heart of the lining grows over them.

Other surgeries depend on whether the defect is partial or complete, and what other problems of the heart there's.

For a partial atrioventricular canal defect, surgery to repair the mitral valve is necessary so that the valve closes tightly. If the repair is not possible, the valve might need to be replaced.

For a complete atrioventricular canal defect, surgeons separate the large single of the valve between the upper and lower chambers of the heart into two valves. If this is not possible, the mitral and tricuspid valves may need to be replaced.

Many people who have corrective surgery for atrioventricular canal defect do not need more surgery. However, some complications, such as leakage of the valve of the heart, may require treatment.

The follow-up care

After congenital heart defect surgery, regular checkups are necessary for life, by a doctor trained in heart disease. This type of care is called a cardiologist. Your doctor will tell you how often you need an appointment or imaging tests.

Adults with congenital heart disease treated in childhood may need attention of an adult congenital cardiologist. Special attention and care may be needed in all the future time of the surgical procedures, even those that do not involve the heart.

The use of preventive antibiotics

Sometimes, a congenital defect of the heart can increase the risk of infection in the lining of the heart or of the heart valves. This infection is called infective endocarditis. You or your child may need to take preventive antibiotics before certain dental and surgical procedures, if you:

  • Are heart problems after surgery
  • He received an artificial heart valve
  • Received artificial or prosthetic material in the heart for the repair

Ask your son or health care provider if the use of preventive antibiotics are necessary.

Coping and support

Many children with heart problems present from birth, grow and lead a healthy life.

But to have a congenital defect of the heart or the care of a child with one of them can be a challenge. These tips can be helpful.

  • Seek support. You may find that talking with others who have experienced the same situation brings comfort and encouragement. Ask your health care provider if there are support groups in your area.
  • Registry or your child's health history. Record the medications, surgery and other procedures, and the dates on which they were made. Include the medical report of the surgeon, and other important information about your or your child's care. This information will be useful for health care providers who are not familiar with you or your child. It will also help your child in the transition from pediatric to adult providers.
  • Ask about sports and other activities. Many people with successful repair of a congenital heart defect usually have no activity restrictions. But some people with a congenital heart defect may need to limit your exercise or sports activities. Your health care provider may say that the sports and types of exercise are safe for you or your child.

Preparing for your appointment

You or your child may be referred to a physician trained in the heart, called a cardiologist.

What you can do

  • Write down all your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of all your medications, vitamins and supplements, including doses.
  • List important medical information, including other health conditions you have or your child has.
  • Write questions to ask their health care provider.
  • Find out if your family has a history of heart disease.

What to expect from your doctor

Your health care provider is likely to ask many questions, such as:

  • When he noticed the symptoms? Are continuous or occasional?
  • What, if anything, makes the symptoms worse or better?
  • Do you have diabetes or a viral infection, such as measles during pregnancy?
  • Did you take medications during pregnancy?
  • Does the use of tobacco or alcohol during pregnancy?

Questions to ask your doctor

For atrioventricular canal defect, some of the questions may include:

  • What is the most likely cause of these symptoms?
  • What tests are needed? Is there any special preparation for them?
  • What treatment do you recommend it?
  • How can we manage other health problems along with atrioventricular canal defect?

Don't hesitate to ask other questions you have.

Symptoms and treatment of Atrioventricular canal defect