Treatments

The treatment of congenital heart defects is often expensive and emotionally draining. Successful treatment requires highly specialized care (American Heart Association, 2001).

The first successful open heart surgery was performed in 1952 when Dr. John Lewis repaired an atrial-septal defect in a five-year-old girl (Kleinert, 2001).

The Patch Operation
This is one of the simplest reconstructive surgeries for congenital heart disease, usually for septal defects. A patch is placed over the opening to correct the shunting (Abdallah, 2001).

The Norwood (3-stage) Surgical Procedure (Claxon-McKinney, 2001)
This procedure involves reconstruction of an infant's heart and supporting vessels. Often used when there is an anomaly of the left ventricle, the Norwood allows the right ventricle to act as a systemic chamber. Repair is done in three stages because an infant's pulmonary vascular resistance is too high.
Stage 1) Newborns: Establishes a permanent unobstructed outflow from the right ventricle to the aorta and regulates pulmonary blood flow.
Stage 2) At 6 months old: Also known as the Hemi-Fontan Procedure or the Glenn procedure; Involves removal of the ventricular volume overload imposed by the systemic shunt and connection of the superior vena cava to the pulmonary arteries, thus reducing ventricular volume load and increasing tissue oxygenation (by separating pulmonic and systemic circulation).
Stage 3) At 2 years old: Also known as the Fontan Procedure; Completes the separation of the pulmonary and systemic circulation by channelling the inferior vena cava blood flow to return to the pulmonary arteries.

Alexandra: Post-Op http://www.geocities.com/kiss_fan66/savannah.htm permission pending

Prostaglandin E is a drug that provides a viable alternative pathway for oxygenating blood in infants who would die if their ductus arteriosus closed, which is often provided to an infant until reconstructive surgery can be performed.

The Clip Procedure (Abdallah, 2001)
A clip is placed on the ductus arteriosus to close it when an infant has patent ductus arteriosus. An alternate procedure is the Coil Operation which is performed through cardiac catheterization.

Children who have private insurance often undergo surgery at a younger age than those who are in managed care programs. Surgery for patients on Medicaid occured at an even later age (Lampe, 2000a).
A negative correlation occurs between the case volume of surtical centers and the median age at operation: those centers that perform more congenital heart defect surgery operate at a much younger age. It has not yet been proven, but is suspected, that operations which occur at a younger age have an increased beneficial result (Lampe, 2000a).