This section describes some of the most common heart defects and heart conditions babies have in the NICU:
• Bradycardia• Coarctation of the aorta• Heart valve abnormalities• Hypoplastic left heart syndrome• Patent ductus arteriosus• Septal defects• Tetralogy of Fallot• Transposition of the great arteries
bradycardia (bray-dee-KAR-dee-uh)What it is: An unhealthy, slow heart rate often caused by interrupted breathing called apnea. NICU staff may talk about apnea and bradycardia as A’s and B’s.
Treatment: NICU staff put sensors on the baby’s chest. These sensors do not hurt the baby. They send information about his breathing and heart rate to a monitor. If the baby's heart rate is too slow, an alarm beeps. A baby with bradycardia may get medicine or breathing support.
coarctation of the aorta (koh-ark-TAY-shuhn of the ay-OR-tuh)What it is: A heart defect present at birth in which the aorta (the large artery that sends blood from the heart to the rest of the body) is too narrow for the blood to flow well.
Treatment: Sometimes doctors can open up the aorta. They put a thin tube into the aorta that has a small balloon at the end. Once in place, the doctors put air into the balloon to help open the aorta. Other times a baby needs surgery to fix the condition.
heart valve abnormalities (hart valv ab-nor-MAL-uh-teez)What it is: When a baby’s heart valves are too narrow, closed, blocked or don’t close properly so blood can’t flow smoothly. A heart valve is part of the heart that opens and closes with each heartbeat.
Treatment: Sometimes doctors can open up the valve. They put a thin tube into the heart valve that has a small balloon at the end. Once in place, the doctor puts air into the balloon to help open up the valve. Other times, surgery is needed to fix the valve.
hypoplastic left heart syndrome (hye-poh-PLASS-tik left hart SIN-drohm)What it is: A serious heart defect present at birth in which parts of the left side of the heart don’t develop the right way. In babies with this condition, the left side of the heart can’t send enough blood to the body. This means the right side of the heart has to work harder to keep blood moving to the lungs and the rest of the body. The right side can do this extra work for a while. But over time, the right side of the heart begins to fail.
Treatment: Babies with this problem may need help breathing with a mechanical ventilator (a machine that breathes for a baby when he is not breathing on his own or needs help breathing). They also need medicines and surgery. There are two main types of surgeries. One is a series of three surgeries to create normal blood flow in and out of the heart. The other is a heart transplant in which the baby’s damaged heart is taken out and replaced with a healthy heart.
patent ductus arteriosus (PAT-uhnt DUK-tuss ar-tuh-ree-OH-suss)What it is: Also called PDA. When part of a baby’s heart doesn’t close normally after birth, causing problems with blood flow. In a healthy baby before birth, much of the blood goes through a passageway (called the ductus arteriosus) between blood vessels and doesn’t go through the lungs. This passageway closes soon after birth so that blood takes the normal route from heart to lungs and back again. If a baby has PDA, the passageway doesn’t close and blood doesn’t flow correctly. PDA is the most common heart condition in premature babies (born before 37 weeks of pregnancy).
Treatment: In some cases, medicine can help close the passageway. If medicine doesn’t work, the baby may need surgery to close it.
septal defects (SEP-tuhl DEE-fekts)What it is: Heart defects present at birth in which there’s a hole in the wall (called a septum) that divides parts of the heart. Because of this hole, the blood can’t flow the way it should, and the heart has to work extra hard. If the hole is between the upper two parts of the heart, it’s called an atrial septal defect (also called ASD). If the hole is between the lower two parts of the heart, it’s called a ventricular septal defect (also called VSD).
Treatment: Small holes may heal by themselves. Other holes need to be fixed by inserting a device through a tube (called a catheter) into a large vein (a blood vessel that brings blood back to the heart) or by surgery.
Tetralogy of Fallot (teh-TRAHL-uh-jee of fa-LOH)What it is: A heart condition present at birth in which heart defects keep the right amount of blood and oxygen from getting to the lungs. This causes the baby’s skin to turn blue (called cyanosis). It may cause growth problems for a baby.
Treatment: Most babies have open-heart surgery to fix the defects. Some babies have a different kind of surgery to put a thin tube (called a shunt) into the heart. The shunt helps increase blood flow to the lungs.
transposition of the great arteries (trans-puh-ZI-shuhn of the great AR-tur-eez)What it is: When the two arteries that carry blood to the heart and from the heart to the rest of the body are reversed so the body doesn’t get enough oxygen.
Treatment: Surgery can correct the position of the arteries.
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