Atrioventricular Canal Defect

What is Atrioventricular Canal Defect?

This is a type of congenital defect in center of the heart, due to a combination of several problems related to the heart. Often associated with Down syndrome, this is also referred to as ‘endocardial cushion effect’ or ‘atrioventricular septal defect’. A heart has two upper and two lower chambers. The upper chambers also called the right and left atria, receive incoming blood. The lower chambers, also called the right and left ventricles, pump blood out of your heart. The valves of the heart are the gates that control the quantity and direction of blood flow. Around 1.5 lakh infants in India are born with congenital heart disease (CHD) and approximately 78,000 of them die because of lack of awareness and improper medical treatment. If not treated at the right time, this could result not only in high blood pressure, but also in heart failure. Generally, it is recommended to operate, to close the hole and reconstruct the valves surgically.

Atrioventricular canal defect occurs when there are problems with the valves of the heart that regulate blood flow and there is a hole between the heart’s chambers. Your heart would, therefore, pump in excess of blood to the lungs, causing over-working of the heart in turn. Due to overwork, the muscles in the heart tend to enlarge. There are two types of atrioventricular canal defect: If the defect is between the two upper chambers, it is called ‘partial atrioventricular canal defect’; If the defect is between all the four chambers, it is called ‘complete atrioventricular canal defect’.

Symptoms

The symptoms of complete atrioventricular canal defect tend to get displayed during the first few weeks of life. They are similar to those of heart failure. Symptoms are greatly affected by the number, type and severity of defects.

Some common symptoms are:

  • Discoloration of lips and skin
  • Poor weight gain and lack of appetite
  • Rapid breathing or difficulty in breathing
  • Irregular or rapid heartbeat
  • Excessive sweating
  • Swelling in legs

Causes

Many factors could contribute to a baby developing complete atrioventricular canal defect while still in the mother’s womb. They include:

  • Having a parent with a history of congenital heart defect
  • Smoking and alcohol consumption during pregnancy
  • Down syndrome
  • Viral illness such as German measles during early stages of pregnancy
  • Poorly controlled diabetes of the mother
  • Taking medication during pregnancy without consulting a doctor.

Risks

Your baby could be at a risk of developing complete atrioventricular canal defect due to the following factors:

  • Rubella or viral illnesses during early pregnancy
  • Down syndrome
  • Consumption of alcohol and tobacco during pregnancy
  • Parents with congenital heart defects
  • Poorly controlled diabetes during pregnancy

Prevention

Because the disease is congenital, nothing can be done for the prevention of complete atrioventricular canal defect. Immunization of children with rubella vaccine has been one of the most effective preventive strategies against congenital heart defects.

How is it diagnosed?

It is possible for your doctor at Medanta to detect atrioventricular canal defect before the baby is born, by using Ultrasound and special heat imaging. The doctor might hear a ‘heart murmur’ o...

How is it treated?

At Medanta, complete atrioventricular canal defect is treated by surgically closing the hole in the septum, using one or two patches. These patches stay in the heart permanently, becoming a part of the septum as the heart’s lining grows over the..

  • Surgery

    The surgery also includes separation of the single valve into two valves, on the left and right sides of the repaired septum. If separating the single valve isn't possible, heart valve replacement might be needed. A successful surgery enables your ward to lead a normal life without restrictions on daily activities. But the child will need lifelong follow-up care with a cardiologist trained in congenital heart disease. Your cardiologist will likely recommend a follow-up exam once a year or more frequently if problems, such as a leaky heart valve, remain. Antibiotics are used to prevent a bacterial infection of the lining of the heart (endocarditis). Many people who have corrective surgery for atrioventricular canal defect do not need additional surgery. However, some complications, such as heart valve leaks, may require treatment.

When do I contact the doctor?

If your child has symptoms like difficulty in breathing, wheezing, lack of appetite, poor weight gain, and bluish discoloration of lips and swelling in legs, contact your doctor immediately.

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