A patent ductus arteriosus (PDA) is an abnormal communication between the aorta and pulmonary artery that allows for oxygenated (red) blood to pass into the lungs. If the amount of blood flowing through the PDA is enough to cause problems, then intervention may be indicated. This most commonly occurs in the setting of a large or moderate size PDA. Indications for intervention in infancy include symptoms unresponsive to medication, elevated blood pressure in the lungs, and significant dilation of the heart due to excess blood flow. Usually the need for intervention in infancy becomes clear by 6-12 months of age, and often much earlier.

Tetralogy of Fallot was originally described in 1672, and was later named after Dr. Étienne-Louis Arthur Fallot in 1888. Tetralogy of Fallot consists of four findings, a ventricular septal defect (hole in the lower wall of the heart), pulmonary stenosis (narrowing in the outflow of blood to the lungs), an overriding aorta, and right ventricular hypertrophy. The first two findings, the VSD and pulmonary stenosis, are what determine the significance of tetralogy of Fallot.

A ventricular septal defect (VSD) is a hole in the ventricular septum, the lower wall of the heart separating the right and left ventricles. Surgery is occasionally necessary in a baby or child to close a ventricular septal defect. This most commonly occurs in the setting of a large or moderate size hole. Indications for surgery in infancy include symptoms unresponsive to medication, elevated blood pressure in the lungs, and significant dilation of the heart due to excess blood flow. Usually the need for surgery in infancy becomes clear by 6-12 months of age, and often much earlier. Less common indications for surgery are infection of heart tissue due to the VSD, or damage to the aortic valve secondary to the VSD.

A small ventricular septal defect is a congenital heart defect, or a birth defect of the heart. Congenital heart defects are the most common form of birth defects, occurring in approximately 1 in 150 children. A ventricular septal defect (VSD) is the most common congenital heart defect; the overall incidence is 3-4 per 1000 children. There are many different types of VSD’s. The most common type, termed a muscular VSD, is formed when the muscle of the wall fails to completely seal. The majority of muscular VSD’s are very small and rarely of any physiologic consequence. Less common types of VSD’s include membranous, inlet and outlet types. These types are often larger and may impose a hemodynamic burden.

Surgical intervention is occasionally necessary in the setting of congenital heart disease. Heart lesions commonly requiring surgical intervention include ventricular septal defect, atrial septal defect, tetralogy of Fallot, coarctation of the aorta, patent ductus arteriosus, transposition of the great arteries, and tricuspid atresia. Pediatric Heart Specialists has all the tools needed to make an accurate and informed diagnosis, and when necessary, refer your child for further surgical care.

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