About Atrioventricular Septal Defect

Atrioventricular Canal Defect Animation

An animation depicting a heart with atrioventricular canal defect.

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Complete Common Atrioventricular Canal Defect, also known as Atrioventricular Septal Defect, is a lack of separation of the atria and the ventricles into separate right and left chambers as well as a lack of separation of the mitral and tricuspid valves. The lack of separation of these two valves results in a single atrioventricular valve.

In patients with atrioventricular canal defect, the single atrioventricular may not close properly. Therefore, the heart must pump an excessive amount of blood and this may result in an enlargement of the heart.

Surgical repair for atrioventricular canal defect is required within the first six months of life. The surgery involves sewing patches over the ASD and VSD and carefully separating the single atrioventricular valve into two valves.


How Does Atrioventricular Canal Defect Differ From
Normal Cardiac Anatomy?

If your child has atrioventricular canal defect the structure of his or her heart is different from normal cardiac anatomy.

 
Learn More About Normal Cardiac Anatomy

Heart With Normal Cardiac Anatomy

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When your child has a congenital heart defect, there's usually something wrong with the structure of his or her heart's structure.

The heart is composed of four chambers. The two upper chambers, known as atria, collect blood as it flows back to the heart. The two lower chambers, known as ventricles, pump blood with each heartbeat to the two main arteries (the pulmonary artery and the aorta). The septum is the wall that divides the heart into right and left sides. The atrial septum separates the right and left atria; likewise, the ventricular septum separates the two ventricles.

There are four valves that control the flow of blood through the heart. These flap-like structures allow blood to flow in only one direction. The tricuspid and mitral valves, also known as the atrioventricular valves, separate the upper and lower chambers of the heart. The aortic and pulmonary valves, also known as the arterial valves, separate the ventricles from the main arteries. Oxygen-depleted blood returns from the body and drains into the right atrium via the superior and inferior vena cavas. The blood in the right atrium then passes through the tricuspid valve and enters the right ventricle.

Next, the blood passes through the pulmonary valve, enters the pulmonary artery, and travels to the lungs where it is replenished with oxygen. The oxygen-rich blood returns to the heart via the pulmonary veins, draining into the left atrium. The blood in the left atrium passes through the bicuspid, or mitral, valve and enters the left ventricle.

Finally, the oxygen-rich blood flows through the aortic valve into the aorta and out to the rest of the body.

Congenital Heart Defects

What Is a Heart Defect?

A heart defect is a problem in the heart's structure. Kids who have a heart defect were born with it. Heart defects are often called "congenital," which means "present at birth." Heart defects are also sometimes referred to as "congenital heart disease."

Heart defects can range from mild to severe.

What Are the Types of Heart Defects?

Types of congenital heart defects include:

How Are Heart Defects Treated?

Children with minor heart defects may not need any treatment. But some babies have serious symptoms that need medical or surgical treatment within the first year of life. They'll be cared for by:

  • pediatric cardiologists: doctors who specialize in treating children's heart problems
    or
  • pediatric heart surgeons: doctors who specialize in children's heart surgery

Procedures done through cardiac catheterization — such as balloon angioplasty or valvuloplasty — can widen an obstructed blood vessel or valve. Another procedure, transcatheter device occlusion, can close abnormal openings or holes within the heart or blood vessels without surgery.

Some problems, such as small- or moderate-sized ventricular septal defects, may close or get smaller as a child grows. While waiting for the hole to close, the child might have to take medicines.

Complex defects found early might need a series of operations that are finished when a child is about 3 years old.

What Happens After Treatment?

Kids treated for a defect (surgically or medically) will need regular visits with a pediatric cardiologist. At first, these visits might happen often — perhaps every month or two. Later, they might be cut back, sometimes to just once a year.

The cardiologist may use tools like X-rays, electrocardiograms (ECGs), or echocardiograms to watch the defect and the effects of treatment.

Some physical activities might be limited, but kids can still play and explore with friends. Always check with the cardiologist about which activities are OK for your child and which to avoid. Some competitive sports could be off limits, for example.

Preventing Infection

Infective (or bacterial) endocarditis is an infection of the tissue that lines the heart and blood vessels. Kids with heart defects used to get  antibiotics before procedures that could let bacteria get into the bloodstream, such as:

But now, preventive antibiotics are given only to some children with heart defects. This includes those who:

  • have a type of congenital heart disease that causes cyanosis (bluish color of the skin)
  • have had infective endocarditis before
  • had their defect repaired with prosthetic material (like an artificial heart valve) or device

The cardiologist will know the latest guidelines, and can advise you based on your child's diagnosis.

Kids with heart defects should take good care of their teeth. They should brush and floss daily, and have regular dental visits and cleanings as often as the dentist recommends.

Looking Ahead

Most heart defects are now treated during infancy. So when your child is old enough to understand, explain what happened. Talk about why your child:

  • has a surgical scar
  • needs to take medicine
  • has to visit the pediatric cardiologist

Describe the treatment in a way your child can understand.

It can be tempting to be very protective. But help your child lead as normal a life as possible. Talk with your cardiologist or the care team about safe ways to do this. They are there to support your child and the whole family.

It also can help to look for local and online support groups. This can connect you to other families who can share what works for them.

What Else Should I Know?

As kids get older, it's important to help them learn how to take charge of their medical care. A younger teen could fill a prescription or schedule an appointment. Older teens should understand health insurance coverage and know how to access their medical records.

Help an older teen move from a pediatric cardiologist to one who cares for adults. He or she should play an active role in choosing the new doctor. Encourage your child to make appointments, ask questions and take notes, and set aside time to speak with the doctor alone.

To prepare for adulthood and manage their health care, teens should know:

  • about their heart condition
  • when to get care
  • the names of all medicines, their dosages and when to take them, common side effects, and interactions with other medicines
  • if they have allergies to food or medicine
  • the answers to most questions about their health and medical history
  • how to:
    • schedule appointments
    • order prescription refills
    • contact the care team
    • manage medical tasks outside of home
  • what problems can happen if they don't follow the treatment plan
  • about their insurance coverage
  • to always carry their insurance information with them

Reviewed by: Kate M. Cronan, MD
Date reviewed: October 08, 2018