Heart conditions

This list contains the most common types of congenital heart disease we treat. We also treat rare and very rare conditions.

Please click on the links under each condition to see information and cartoons explaining the conditions, provided by the Children´s Heart Federation.

Conditions and treatments

Anomalous pulmonary venous connection (APVC) is when all veins from the lungs are connected to the right (instead of the left) collecting chamber (atrium) of the heart.

Treatment

It's usually diagnosed by echocardiogram and occasionally MRI. The type of abnormal connection (partial or total), determines whether surgery needs to be carried out urgently or not. An interventional approach is only carried out as a rescue treatment.

Coarctation (CoA) of the aorta is when the main body artery narrows, impairing the blood supply to the lower half of the body.

Treatment

Diagnosis and treatment for babies is based on clinical findings (such as weak pulses in the legs) and echocardiography. Typically treatment is surgery, but occasionally heart catheterisation may be the treatment of choice.

In older children, diagnosis is based on clinical findings (such as weak pulses in the legs and high blood pressure), echocardiography and MRI. Treatment depends on the type of lesion.

Surgery may be recommended, but in teenagers and adults, interventional heart catheterisation is usually the preferred treatment.

Complete atrio-ventricular septal defect (AVSD) occurs when, instead of two valves connecting the two collecting chambers (atria) with the two pumping chambers (ventricles), there is only one valve connecting all four chambers of the heart.

Treatment

Diagnosis is usually established by echocardiography and ECG (electrocardiogram).

This heart condition is treated surgically. The timing of surgery is dependant on the size of the defect (hole) and how well the cardiac valves are working.

Hypoplastic left heart syndrome (HLHS) occurs where the left pumping chamber is underdeveloped.

Treatment

This very complex heart condition has been treated at Evelina London since 1992. Treatment usually involves three operations:

carried out in the neonatal (newborn) period
in the first year of life
between the ages of two and five

Since 2005, some patients have been able to have a combined surgical and interventional approach, avoiding cardiopulmonary bypass (hybrid operation).

Persistent ductus arteriosus (PDA) occurs when the arterial duct does not close. The arterial duct is a shortcut between the lung arteries and the main body artery (the aorta), which is necessary during pregnancy. This usually closes after birth, but in some people it doesn’t.

Treatment

Whilst preterm babies typically require surgery, later in life this condition can be treated with catheter techniques.

The lungs are typically supplied by an arterial duct. Pulmonary atresia with an intact ventricular septum occurs when the valve connecting the right pumping chamber of the heart (right ventricle) and the main artery to the lungs (pulmonary artery) does not open. The right ventricle can be underdeveloped.

Treatment

Depending on the size of the right ventricle, it may be possible to open the blockage with a heart catheterisation to balloon the valve and in some cases insert a stent at the arterial duct. If the right ventricle grows well enough, surgery may not be necessary.

Pulmonary atresia with ventricular septal defect occurs when the valve connecting the right pumping chamber of the heart (right ventricle) and the main artery to the lungs (pulmonary artery) does not open. In addition, there is a connection between the two pumping chambers of the heart. Often, the lungs are supplied with blood by an arterial duct and/or abnormal vessels, so-called collateral arteries.

Treatment

Treatment depends on the size of the ventricles and the vessels connected to the heart. In most cases this involves surgery.

Tetralogy of Fallot (ToF) occurs when the part of the wall between the pumping chambers close to the valves is too far towards the right, leading to a narrowed valve between the right chamber and the lung arteries, a hole between the pumping chambers (VSD) and the aorta overriding this defect. The muscle of the right chamber can be quite thick.

Treatment

Depending on the size of the child, surgery involves one or two steps. In some cases an artificial vessel (called a BT-shunt), is needed first to provide enough blood flow into the lungs to allow the arteries to grow. Later, corrective surgery is carried out. In most cases the shunt is not necessary.