Adult Congenital Heart Defect Repair

People born with a heart condition (congenital heart disease) often have the defect repaired as a child. Other patients require medical intervention or surgery as an adult.

For adults who do require surgical care for their congenital heart conditions, cardiac surgeons at the Structural Heart Disease Program at Brigham and Women’s Hospital (BWH) Heart & Vascular Center provide extensive experience in the full range of congenital heart repair procedures.

We offer comprehensive inpatient and outpatient services from diagnosis to cardiac catheterization and minimally invasive surgical repair for many types of congenital heart defects, including:

  • Atrial septal defects
  • Ventricular septal defects
  • Coarctation of the aorta
  • Valve stenois or regurgitation
  • Tetralogy of Fallot

Although rare, adults with a life-threatening congenital heart defect may require a heart transplant.

With 47,000 outpatient visits each year, the Heart & Vascular Center is one of the largest in the United States, treating over 7,000 inpatients and performing more than 8,000 procedures annually at our state-of-the-art Shapiro Cardiovascular Center.

Adult Congenital Heart Defect Repair

Adult Congenital Heart Defect Repair Procedures

Cardiac Catheterization

Many congenital heart defects can be repaired through outpatient cardiac catheterization techniques. Minimally invasive catheter procedures are usually performed to correct moderately complex defects, such as:

  • Atrial septal defect (ASD) A catheter with a small device attached at the end is guided to the upper chambers of the heart. When the defect has been reached, the device is released to plug the hole between the chambers. Over the next several months, natural tissue grows in and around the device to improve heart function. Learn more about atrial septal defect.
  • Coarctation of the aorta A catheter with a deflated balloon fixed to the end is guided to the narrowing in the aorta. The balloon is inflated to stretch the aorta and to lessen the blockage. A stent (cylindrical metal tube) may be placed inside the blockage after balloon inflation to keep the area open. Learn more about coarctation of the aorta
Minimally Invasive or Open Congenital Heart Surgery

Congenital heart defect repair surgery may be performed with minimally invasive surgery or traditional (open) heart surgery. Surgery may be recommended for the following reasons:

Cardiac surgeons at the Heart & Vascular Center offer a variety of surgical techniques to repair congenital heart defects. Surgical approaches include:

Minimally invasive heart surgery uses small incisions and has fewer post-operative complications, allowing patients to recuperate faster with less pain. This includes:

  • Mini thoracotomy uses a small incision through the ribs
  • Mini sternotomy is done through a small opening that goes from the top of your breastbone down to the third rib.

Open heart surgery means cutting skin and tissues with a wide incision so that your surgeon has a full view of your heart. Types of open surgery are:

  • Sternotomy involves an incision made down the center of your chest separating your breastbone.
  • Thoracotomy involves a nine-inch incision made in your rib cage from under the arm around to the back.
Why Have Adult Congenital Heart Defect Repair?

Adults with congenital heart disease may experience:

  • Heart failure
  • Heart valve problems
  • High blood pressure concerns
  • Irregular heart rhythms

For many congenital heart defects, there are often few or no symptoms. Severe heart defects may cause:

  • Cyanosis (bluish skin, lips, and fingernails)
  • Fatigue
  • Rapid breathing or shortness of breath
  • Chest pain
  • Poor circulation
  • Palpitations: the sensation of rapid or skipped heart beats
  • Fluid buildup in the lungs
  • Swollen ankles, feet, legs, abdomen, neck
  • Abdominal swelling
  • Heart murmurs
  • Cough
  • Heart failure
  • Lightheadedness or loss of consciousness

Surgical intervention by an experienced cardiac surgeon can alleviate these symptoms and improve quality of life.

What You Should Expect

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

Prior to surgery, you will be scheduled for a visit to the Watkins Clinic in the Shapiro Cardiovascular Center for preoperative information and tests.

The day of surgery, your care will be provided by surgeons, anesthesiologists and nurses who specialize in congenital heart defect surgery. The Heart & Vascular Center is home to one of the most advanced hybrid operating rooms in the country. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

During your surgery, family and friends can wait in the Shapiro Family Center where staff members will provide surgery updates.

Multidisciplinary Care

In addition to our cardiac surgeons, patients also benefit from the teamwork of medical cardiologists, interventional cardiologists, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in cardiovascular disease. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.

Resources

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families.

Access a complete directory of patient and family services.

Learn about the Watkins Clinic in the Shapiro Cardiovascular Center.

LEARN MORE ABOUT BRIGHAM AND WOMEN’S HOSPITAL


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