Atrioventricular septal defect in neonates

The article was professionally consulted by Specialist Doctor II Cao Thi Thanh - Pediatrician - Department of Pediatrics - Neonatology - Vinmec Hai Phong International General Hospital. Dr. Thanh has worked for 25 years in the treatment of neonatal pediatric diseases.

Atrioventricular septal defect in newborns is a disease that requires surgery as soon as the baby is born 2-4 months old. This is an extremely dangerous disease and accounts for a high incidence in congenital heart diseases in general.

Atrioventricular septal defect or atrioventricular canal is a congenital heart defect that accounts for 4-5% of congenital heart disease in general. This is a congenital heart disease with a T-P shunt, the disease often progresses seriously, causing complications such as severe pneumonia, heart failure, arrhythmia, infective endocarditis, especially persistent pulmonary arterial hypertension. lead to high mortality and premature adulthood.
Atrioventricular septal defect can generally be divided into 3 branches:
Complete atrioventricular septal defect: with large receiving chamber part ventricular septal defect (unrestricted); Medial ventricular septal defect: with small or moderate (limited) ventricular septal defect; Partial atrioventricular septal defect: no ventricular septal defect. According to the survey, the majority of neonates with complete atrioventricular septal defect will often have accompanying Down syndrome. If the atrioventricular septal defect is accompanied by Down's disease, the prognosis is poor. In addition, patients with splenomegaly or polysplenic syndrome (isomer) often present atrioventricular septal defect.

Before the infant turns 1 year old, this congenital heart defect will often appear with clinical manifestations with main symptoms such as:
Newborns eat poorly, suck little, sleep irregularly; Children's weight increases more slowly than normal children; Children appear to have shortness of breath when exerting themselves or when eating and breathing rapidly; Frequent sweating; Fatigue, reduced exercise capacity; Have recurrent pneumonia; Enlarged liver; Big heart, increased heart load. It is possible to observe that the anterior chest area appears deformed, the heart beats wide and multi, and hyperactive; Newborns with moderate or severe atrioventricular septal defect will often show signs of heart failure. Cases with combined Down syndrome are more likely to lead to fixed pulmonary hypertension because the Down patient himself has pathology of the pulmonary vascular bed.

In order to diagnose the atrioventricular canal accurately, when examining the baby, the doctor will appoint the baby to do the necessary tests such as:
X-ray; Listen to the heart; Echocardiography . Physical examination is suggestive when making the diagnosis of an atrioventricular septal defect in the neonate, supported by chest radiographs and electrocardiogram (ECG) and confirmed by 2-D echocardiography. combined with blood flow Doppler ultrasound and color ultrasound.
Chest X-ray: shows enlarged right atrial and biventricular dilatation, raised pulmonary artery arc, and dark pulmonary vascular sign. Electrocardiogram: shows a QRS electrocardiogram axis, atrioventricular block (AV block) is usually grade I, right or left ventricular hypertrophy, or both, will be seen on the electrocardiogram. In addition, right atrial dilatation and right bundle branch block may also be present. Two-dimensional ultrasound combines blood flow Doppler and color ultrasound: the obtained ultrasound images help doctors confirm the diagnosis, as well as provide anatomical and hemodynamic information. Unless hemodynamic assessment is required prior to surgery, cardiac catheterization is not usually necessary. SEE ALSO: When should surgery for atrioventricular canal congenital heart disease

Atrioventricular septal defect in newborns is one of the complex congenital heart diseases, often accompanied by Down syndrome, so medical treatment is often ineffective, most of them will be indicated by methods of treatment. atrioventricular floor bypass surgery. The time to perform total surgery is usually between the ages of 2 and 4 months, no later than 6 months of age to prevent the development of pulmonary vascular disease, especially in children with Down syndrome.
For severe and rapidly increasing heart failure cases that are difficult to control under medical treatment, surgery can be performed earlier, depending on the treatment regimen of the attending physician. Perform temporary surgery for hypoplastic cases.
There are 3 types of atrial septal defect in newborns, in which complete atrioventricular septal defect is a serious disease requiring early detection and surgical treatment. If the baby is unfortunate enough to have this congenital heart defect, parents should take the child to a cardiologist at a reputable medical facility to be examined and have the right treatment plan in a timely manner, providing a better prognosis. high disease treatment.
With many years of experience in examining and treating cardiovascular diseases in children, now Vinmec International General Hospital has become one of the major health care centers, capable of examining, Screening and intensive treatment of many cardiovascular diseases in children. In particular, Vinmec has diagnosed and detected many cases of pregnant women whose fetuses have very severe heart defects, and at the same time performed surgical intervention to treat them early from the day they were born, providing a high prognosis for survival. for many babies, bringing joy and happiness to many families.
Therefore, if the child has signs of congenital heart disease or detects the disease while in the fetus, they can go to Vinmec International General Hospital for examination and surgical treatment to improve the quality of life for children. children later.