Congenital Heart Disease – Treatment at Sheba Medical Center

Congenital heart disease is the most common type of birth defect. It is a structural problem that occurs when the heart or major blood vessels do not develop properly, generally between 2½ to 7½ weeks after conception. Nowadays, many advanced therapies and procedures are available to treat congenital heart disease, and the chances of overcoming the problem and living a normal adult life are better than ever.

What are the risk factors for congenital heart defects?

At the comprehensive Edmond J. Safra International Congenital Heart Center at Sheba Medical Center in Israel, we provide every resource that a heart patient needs. Our world-class cardiothoracic surgeons perform approximately 400 surgeries and 300 catheterization procedures per year, and our highly trained, compassionate specialists offer treatment for more than 150 congenital heart defects.

While it is impossible to always predict when congenital heart disease will occur, there are factors that raise the risk for certain pregnant women. Women with these risk factors are recommended to undergo a fetal echocardiogram to inspect the health of the fetus.

The most common risk factors include:

• Family history
• Genetic or chromosomal problems in the fetus, such as Down syndrome
• Diabetes on the mother’s side
• Prenatal exposure to specific medications
• Drug or alcohol abuse during pregnancy
• First-trimester exposure to German measles (rubella)

What are the types of congenital heart disease?

There are at least 18 distinct types of congenital heart defects, with numerous anatomical variations. The most common types are:

• Atrial septal defect: a hole in the wall between the heart’s upper chambers
• Patent foramen ovale: also caused by a hole in the wall between the heart’s upper chambers
• Ventricular septal defect: a hole in the wall between the heart’s lower chambers
• Patent ductus arteriosus: the blood vessel connecting the aorta and the pulmonary artery does not close properly after birth
• Aortic stenosis: the heart valve to the body is narrowed
• Pulmonary stenosis: the heart valve to the lungs is narrowed
• Tetralogy of Fallot: a heart defect with four problems – a hole between the lower chambers of the heart, an obstruction from the heart to the lungs, the aorta (blood vessel) lies over the hole in the lower chambers, and the muscle surrounding the lower right chamber becomes overly thickened
• Coarctation of the Aorta: a segment of the aorta is too narrow for proper blood flow
• Transposition of the great arteries: the positions of the aorta and the pulmonary artery are reversed when leaving the ventricles
• Hypoplastic Left Heart Syndrome: the left ventricle is so undeveloped that it cannot pump efficiently
• Pulmonary Artery Stenosis: a segment of the pulmonary artery is too narrow for blood to flow properly
• Pulmonary Hypertension: scarring of the small arteries in the lungs

What are the symptoms of congenital heart disease?

The symptoms of congenital heart disease vary depending upon age.

In newborns, the signs can include:

• Rapid breathing
• Deep rib retraction during breathing
• Bluish tint in the skin, lips, and fingernails (cyanosis)
• Fatigue
• Poor feeding
• Lung infections
• Poor weight gain

In older children, the signs of a congenital heart defect can include:

• Fatigue
• Low tolerance for exercise
• Rapid or labored breathing either at rest or with exercise
• Swollen feet, ankles, and legs
• Loss of consciousness
• Loss of appetite
• Unexplained chronic stomachache

What treatments does Sheba offer for congenital heart disease?

At Sheba, our medical team is dedicated to treating patients with congenital heart disease so they experience maximum comfort and minimal pain. We treat a wide variety of congenital heart defects and perform many advanced and complex surgical interventions, sometimes in combination with cardiac catheterization. At our state-of-the-art Congenital Heart Center, pediatric surgeons can perform surgeries for heart disease on low weight newborns (less than 2.5 kg).

In addition, Sheba doctors have developed a minimally invasive, unique method to treat particular types of congenital heart defects. Using this technique, our surgeon performs the operation through a cosmetic incision beneath the breast, so scarring is not visible in the future.

We provide many types of treatments, including:

• Transposition of the Main Arteries
• Left Heart Hypoplasia Syndrome
• Tetralogy of Fallot, Unifocalization of Pulmonary Atresia and Major Aortopulmonary Collateral Arteries (MAPCAs)
• Single Ventricles
• Valve Repair: Aortic, Mitral, and Tricuspid Valves
• Intracardiac Reconstruction of Complex Malformations
• Remodeling of Left Ventricular Outflow Tract with the Ross Procedure and Nikaidoh Procedure
• Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD) and Atrioventricular Canal Defect Repairs