Congenital Heart Disease - Treatment
Our goal in treating children with congenital heart disease is to use the least invasive therapy that offers the highest chance for success. Treatment decisions are made on a case-by-case basis, in collaboration with our colleagues in pediatrics and pediatric cardiology. As part of a world-class academic medical center, we are able to offer patients the full range of therapies and the latest technologies, including some treatments not available at other institutions.
Therapies for congenital heart disease vary widely, depending on the type and severity of the abnormality. Medical therapy and watchful waiting may be all that is required for certain conditions, such as small- or medium-sized septal defects, which often close or reduce in relative size as the child ages.
Because of technological advances, some serious heart defects can now be treated in the cardiac catheterization laboratory, rather than in the operating room. Certain septal defects (holes in the heart), for example, can be repaired with a tiny umbrella-like device, which is put into place with a catheter (a long, slender tube) that is inserted into an artery and then threaded into the heart. Once the device is correctly positioned, the "umbrella" is opened, sealing off the unwanted hole. Other catheter-based interventions employed at NYU include coil occlusion of patent ductus arteriosus, stenting and balloon dilation of obstructed pulmonary and venous pathways, and radiofrequency ablation of arrhythmias.
Patients who are not candidates for these less-invasive procedures will require surgical treatment. Fortunately, many abnormalities can be corrected with a single operation performed in early infancy. Complex abnormalities may require a series of operations, starting in the first months of life and ending at about age three.
In general, surgery for congenital heart disease in children is performed using a traditional incision through the breast bone. Open-heart surgery has been highly refined over the years, with great extreme reliability and safety even in very small babies.
Whenever possible, we use minimally invasive surgical techniques, similar to those that have been used for years in adult cardiac surgery. These techniques, many of which were pioneered here at NYU, avoid the traditional splitting of the breastbone characteristic of open-heart surgery. Instead, the operation is performed through a much smaller incision between the ribs, resulting in far less postoperative pain and a dramatically shorter recovery - with the same overall success rates as traditional approaches. Often, children can return to school and play within a week.
The vast majority of children with heart defects, even those with complex abnormalities, will spend most of the time at home under their parents' care, requiring only periodic visits to the pediatrician and pediatric cardiologist.
