Infant Heart Defects - VSD and COA

Newborn with a Heart Defect

Like any other serious illness, it is always something that happens to someone else. During my daughter-in-law's pregnancy she told me the baby had a hole in it's heart. Our new baby had a hole in the heart and a narrowing of the aortic arch.

Apparently, one out of every one hundred and twenty-five babies born has some form of heart defect often referred to as Congenital Heart Disease. I was stunned to learn this but also comforted in some small way. Knowing that it is more common than I suspected provided some comfort in the procedures necessary to correct the problems.

A Congenital Heart Disease is simply a problem with the structure of the heart and covers any number of problems or abnormalities. The March of Dimes website tells us the defect may not manifest itself at birth or it may be so severe as to need surgery immediately. It seems these heart defects begin to form in the early weeks of pregnancy as the baby's heart develops. The baby's heart starts beating about twenty-two days after conception. Often the doctor is alerted to the defect or abnormality when there is a heart murmur present. A heart murmur is a sound the heart makes as it pumps blood. Not all heart murmurs mean a severe problem, but they allow the doctor to do further testing to determine exactly what the baby has or does not have.

A children's heart disease specialist can do a fetal echocardiography, a test that uses sound waves to take pictures of the heart. These pictures show the heart in detail and allow the doctor to determine if there is a problem to watch. Sadly scientists do not know what causes these heart problems in newborns. There is speculation and suspect conditions but nothing has been proven. One of the suspects is the mother having had the measles during pregnancy, another is a mother with diabetes. There are also medications that are said to increase the risk of heart defects and pregnant mothers are told not to take them.

Interestingly the placenta does the breathing for the fetus so heart defects only become a problem after birth.

Heart with VSD

A heart with a VSD - ventricular septal defect
A heart with a VSD - ventricular septal defect | Source

A baby after VSD surgery

VSD - Ventricular Septal Defect

There are over thirty-five congenital heart defects in newborns. One of the heart problems newborns face is called Ventricular Septal Defect or VSD. Our baby had VSD. It is the most common heart defect among newborns. VSD is a hole in the wall of the heart between the right and left ventricles. The right and left pumping chambers are separated by the ventricular septum. This hole in the septum or wall, allows oxygen rich blood and oxygen poor blood to mix and then that blood goes back to the lungs.

Before birth, one of the signs of VSD is a heart murmur. If not caught before birth, after birth the baby's lips and finger tips will begin to turn blue. If not detected the VSD can cause heart failure within the first two months of the baby's life. Interestingly more than half of VSD's close by themselves. The other half need surgery. That is determined by the size, location, and severity of the hole. According to kidshealth.org, in surgery;

In this procedure, the surgeon makes an incision in the chest wall and a heart-lung machine will maintain circulation while the surgeon closes the hole. The surgeon can stitch the hole closed directly or, more commonly, sew a patch of manmade surgical material over it. Eventually, the tissue of the heart heals over the patch or stitches, and by 6 months after the surgery, the hole will be completely covered with tissue.

It sounds so easy but when you are talking about a newborn baby it is more than scary.

COA

  • Associated with other abnormalities of the heart
  • Makes up 8% of congenital heart problems
  • Occurs more commonly in boys
  • Usually diagnosed in babies or young children
  • Needs to be treated or it will cause other problems
  • Symptoms may include cold hands and feet, shortness of breath, and chest pain
  • Those diagnosed at birth are corrected by surgery

Narrowing of the Aortic Arch - COA

Narrowing of the aortic arch is also called COA because the narrowing is referred to as a coarctation. It is the fourth most common Congenital Heart Disease. Our baby had a narrowing of the aortic arch. The Children's Hospital of Pennsylvania's website notes that "Children with interruption of the aortic arch almost always also have a large ventricular septal defect (VSD), or a hole in the wall between the two lower, pumping chambers of the heart." It is also noted that blood pressure can be higher before the narrowing and lower after the narrowing.

An ultrasound can detect a COA in the womb. The most common COA is located right after the arch of the aorta. COA must be fixed by open heart surgery to open the narrowed vessel. It is either opened or surgically removed depending on the individual circumstance. If not corrected the overworking of the ventricles will eventually cause heart failure. It appears this heart failure is more rapid in newborns. If not corrected babies will experience poor appetite, trouble feeding or failure to gain weight and thrive. Surgical resection of the narrowed artery is the only cure.

As with other infant heart defects there is no known reason for the occurrence of COA. They just seem to be there by chance.

Though surgery corrects the immediate problem this is not to be dismissed. Yearly checkups with a cardiologist are necessary to ensure there are no further problems. These yearly checkups are necessary for life. It is very important to monitor blood pressure and make sure a narrowing does not reoccur.

After Surgery

Our baby after her surgery
Our baby after her surgery | Source

After Infant Heart Surgery

After your infant has open hear surgery he/she is monitored much like an adult. The baby may still be hooked to a ventilator to help her breathe until the effects of the anesthesia have worn off. You will see IVs providing both medicine and IV fluids. Next, an arterial line will be present to monitor the baby's blood pressure. A nasogastric tube will help keep the baby's stomach free of any acid or gas that built up during the surgery. A chest tube is inserted to keep the chest cavity free of blood as the heart and incision heal. A heart monitor will be connected to allow staff to monitor the baby's heart throughout the recuperation period. Some hospitals also keep an Electroencepholograph hooked up to the baby to watch for any seizure action that would not otherwise be obvious.

What do you remember?

My Granddaughter

As previously mentioned, my granddaughter was born with a VSD and COA. She was born at CHOP, The Children's Hospital of Pennsylvania, the number one children's hospital in the United States. Both of her defects were corrected with open heart surgery three days after she was born. She is now two and a half weeks old and doing well. She still has a feeding tube as bottle feeding makes her tired. It is very important for "heart babies", as the nurses call them, to get proper nutrition. The formula that she is getting is higher in calories than a normal baby formula. She is first fed the bottle to encourage her to eat on her own but if she does not finish the bottle the remaining portion is fed to her through the feeding tube (also referred to as a nasogastric tube).

She is beautiful and seems to be getting stronger every day and eating a little more at each feeding. She amazes me! I look at her perfect features and dainty face as she sleeps and I cannot believe that she has gone through open heart surgery.

The most important lesson here is that babies are born with Congenital Heart Disease but can be helped. Open heart surgery is scary at any age but down right paralyzing for the families of newborns. Research, updated techniques and tests have all led to more accurate and advanced surgical procedures that will benefit your baby. My prayers are with anyone who has to go through this surgery with their newborn.

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Comments 23 comments

billybuc profile image

billybuc 3 years ago from Olympia, WA

I am so happy to hear that she is doing well. Talk about scary! I know we have advanced medical techniques but when it happens to one of yours, the fear is there. Thank you for the information; this should be very helpful to others.


marcoujor profile image

marcoujor 3 years ago from Jeffersonville PA

Oh Mary,

You did an amazing job describing Infant Heart Defects...easy for anyone to understand, yet filled with all the ' need to know' information.

Your grand is simply that...a beautiful gift , an ongoing reminder of the strength even our little ones possess and the importance of a loving, supportive family.

Voted UP and UABI...Love and prayers, Maria


tillsontitan profile image

tillsontitan 3 years ago from New York Author

Thanks Bill. We are relieved and happy too. It was definitely scarier than being pregnant myself! I hope someone else gets just a touch of comfort from reading this.

Thank you Maria. Of course you realize I could've written forever but limited myself to the facts. Thank you for the votes but more for the love and prayers. Love back at you!


hawaiianodysseus profile image

hawaiianodysseus 3 years ago from Southeast Washington state

Hi, Mary!

Congratulations on the latest addition to your family, and thanks be to God for watching over your granddaughter and the medical staff who helped facilitate her arrival.

You did such a great job of breaking down the medical terminology and organizing your presentation in a logical and sequential fashion. I took the quiz and aced it, which is more a reflection of your excellent presentation than my memory. : )

Thanks for sharing this information, Mary. Aloha! Joe


tillsontitan profile image

tillsontitan 3 years ago from New York Author

Thank you HawaiiO, the reflection is on you paying attention be it consciously or subconsciously ;) Our new little granddaughter is a doll and I know the good start she's been given will only improve her chances. Attributable to God, parents, and hospital staff!!

Thank you too for being so quick to read. Aloha!


bdegiulio profile image

bdegiulio 3 years ago from Massachusetts

Hi Mary. So glad to hear that she is doing well. She is beautiful. I am all too familiar with this sort of thing as I was recently disgnose with an Atrial Septum Defect, or ASD, which apparently I've had since birth. It's a long story and I'll spare you the details but take comfort in the fact that your granddaughter can live a normal life. You did a great job explaining this. Voted up, shared, etc..


AudreyHowitt profile image

AudreyHowitt 3 years ago from California

Mary,

First I want to congratulate you on your new granddaughter! And to thank you for this wonderful hub. You did such a wonderful job explaining--my niece had heart surgery as a newborn and she will be 26 soon--it is a huge blessing---


drbj profile image

drbj 3 years ago from south Florida

I can certainly relate to this, Mary, as my two newest great grandbabies both had heart defects at birth which appear to be healing without surgical intervention. Delighted that your new granddaughter is doing well.

Thanks for this interesting information and sharing your research. God bless!


midget38 profile image

midget38 3 years ago from Singapore

This has to be shared with parents anxious to know what happens when their young ones have to go through such processes, which is what I will do. Excellent, Mary!


ChitrangadaSharan profile image

ChitrangadaSharan 3 years ago from New Delhi, India

Many congratulations and all the best wishes for your granddaughter' s health. This hub will certainly help, those anxious parents, who have this health issue.

This reminded me of my friend's daughter, who underwent similar surgery and is quite healthy now. In fact she is 30 years old and married now. Her heart defect was diagnosed within few months after her birth.

Again wishing a healthy life to your granddaughter.


Frank Atanacio profile image

Frank Atanacio 3 years ago from Shelton

You did an excellent job in your description of VSD and Coa, but reading hubs like this and viewing the photos take a lot out of me. I know they are important informative.. but they hurt.. Voted awesome and useful as always with you :)


tillsontitan profile image

tillsontitan 3 years ago from New York Author

Oh Bill, I have read that these defects not diagnosed at birth show up later in life. I am sorry to hear you have one of them. I'm sure it is a long story but I hope it can be corrected to your benefit. Thank you so much for your confidence for my granddaughter and for your votes and share.

Audrey, thank you for your lovely comment. Your congratulations as well as your telling about your niece help add the confidence I need.

drbj I am so glad your great grandbabies did not need surgical intervention and wish them both long and healthy lives.

Thank you too Michelle. That was my intention in writing this hub, that it might help an anxious parent going through this. Your shares are appreciated more than you know.

ChitrangadaSharan, thank you. It is always good to hear of the success stories like your friend's daughter. Your good wishes are so appreciated.

Ah Frank, I know what you mean. It is always so hard to see such little ones go through this, but, thank God they are resilient and do well. Thank you for the compliment, coming from a writer who keeps me on the edge of my seat makes it even more special.


mary615 profile image

mary615 3 years ago from Florida

As a loving Grandmother myself, I can only imagine the emotions you went through during this ordeal. Thankfully, your Grand was born in a facility where apparently the Drs. knew exactly what to do and how to do it.

My thoughts and prayers are with you and your family, and I just now this little beauty will grow and remain well.


MartieCoetser profile image

MartieCoetser 3 years ago from South Africa

Oh, all of this sounds so scary. But so wonderful to know that thanks to medical science heart defects can be rectified immediately after birth.

Mary, I am so glad to know that your grandchild is getting stronger every day. My best wishes also to baby's mommy and daddy.


tirelesstraveler profile image

tirelesstraveler 3 years ago from California

My son and daughter-in-law have friends whose son was born with narrowing of the arteries and a hole in his heart. He is doing well nearly two years later. This is an encouraging article.


wetnosedogs profile image

wetnosedogs 3 years ago from Alabama

What a beautiful baby. And very special. Congratulations, grandma.

I am happy to hear baby is doing well and at home.

Great job is describing. I know it had to be scary for parents and grandparents.

The Lord does indeed do great works.

Sharing this.


tillsontitan profile image

tillsontitan 3 years ago from New York Author

All thoughts and prayers are greatly appreciate Mary. I'm sure all the grandmother's out there can imagine how I was and am feeling.

Yes Martie, knowing they were prepared for her and ready to operate was a comfort. It is amazing what they can do! Thank you GF. I will pass on your wishes.

Thank you Tirelesstraveler, I never tire of hearing success stories! I hope this gives some comfort to others.

WND, thank you. She is a joy. It certainly was scary but faith, hope, prayer and good doctors got us through! I appreciate the share.


Vinaya Ghimire profile image

Vinaya Ghimire 3 years ago from Nepal

Mary, this is very new to me. Thanks for this informative and useful hub.


tillsontitan profile image

tillsontitan 3 years ago from New York Author

You are most welcome Vinaya.


Anthony Boone profile image

Anthony Boone 3 years ago from Connencticut

I find this information helpful, and educational. I work in the medical field, and always enjoy learning something new.


tillsontitan profile image

tillsontitan 3 years ago from New York Author

Thank you Anthony. It was truly a learning experience for me and I am so thankful it turned out so well.


Glimmer Twin Fan profile image

Glimmer Twin Fan 3 years ago

Wow tillsontitan - This was a fascinating hub to read and at the same time difficult. It is hard to imagine the finesse that the doctors must have when performing this surgery. I am so glad that your granddaughter did well. She looks so beautiful and I hope all is going well.


tillsontitan profile image

tillsontitan 3 years ago from New York Author

Yes Glimmer Twin it certainly is scary. Imagining that tiny little heart in the hands of a surgeon, but God bless them they did it right. She is doing very well. She had the feeding tube removed a few days ago!

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