We have a highly skilled team who can provide a wide range of services from diagnosis to treatment.
An atrioventricular septal defect (AVSD) is a heart defect in which there are holes between the chambers of the heart's right and left sides. The valves that control the blood flow between these chambers may not be formed correctly.
Two general types of AVSD can occur, depending on which structures are not formed correctly:
In AVSD, blood flows where it normally should not. The blood may also have a lower than normal amount of oxygen, and extra blood can flow to the lungs. This extra blood being pumped into the lungs forces the heart and lungs to work hard and may lead to congestive heart failure (CHF).
Infants who have surgical repairs for AVSD might still have lifelong complications. The most common of these complications is a leaky mitral valve. This is when the mitral valve does not close all the way so the heart has to work harder to get enough blood to the rest of the body.
When symptoms do occur, they may include:
For partial AVSDs, if the holes between the chambers of the heart aren't large, the signs and symptoms might not be diagnosed for years.
Symptoms that might indicate that a child’s complete AVSD or partial AVSD is getting worse include:
The causes of congenital heart defects, such as AVSD, among most babies are unknown. Some babies have heart defects because of changes in their genes or chromosomes. AVSD is common in babies with Down syndrome, a genetic condition that involves an extra chromosome 21 (also called trisomy 21).
Congenital heart defects are also thought to be caused by environmental factors, such as what the mother eats or drinks or certain medications she uses during pregnancy.
A heart murmur is often the first clue that this heart defect exists. It is typically noted in the first week or two of life and it is not uncommon that no murmur is present at birth.
The diagnosis of AVSD in any form is easily made by an echocardiogram or fetal echocardiogram. Chest X-ray and an electrocardiogram may be used to assist in the assessment. Both may show characteristic findings in AVSDs.
Because of the high incidence of AVSDs in infants with Down syndrome, all infants with Down syndrome should have an echocardiogram, even if they do not have a heart murmur or any of the signs or symptoms discussed above.
Both partial and complete AVSD types usually require surgery. During surgery, any holes in the chambers are closed using patches. If the mitral valve does not close completely, it is repaired or replaced. For a complete AVSD, the common valve is separated into two distinct valves.
The age at which surgery is done depends on the child’s health and the structure of the AVSD. If possible, surgery should be done before permanent damage to the lungs from too much blood being pumped to the lungs.
Medication may be used to treat congestive heart failure, but it is only a short term measure until the infant is healthy enough for surgery.
Infants who have surgical repairs for AVSD are not cured; they might have lifelong complications. The most common complication is a leaky mitral valve. Therefore, a child or adult with an AVSD will need regular follow-up visits with a cardiologist (heart doctor) to monitor their progress, avoid complications, and check for other health conditions that might develop over time.
With proper treatment, most babies with AVSD grow up to lead healthy, productive lives.
Presbyterian’s Pediatric and Congenital Cardiology team has many different options to help you manage your or your child’s heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans. Depending on the type of heart condition your child has and its underlying cause, the team can recommend a wide variety of treatment options. Our pediatric cardiologists, pediatric interventional cardiologists, and pediatric cardiovascular surgeons work closely together for cases in which cardiac repair or surgery is the best treatment option.