Quick summary: Congenital heart diseases present at birth range from mild defects that can be watched to complex ones that need early catheter treatment or surgery, and antenatal scans plus modern paediatric techniques now let teams operate successfully even on babies of very low weight. Children given timely care and planned follow up often go on to lead near normal lives, which eases family strain and supports better long term well being for the child and parents. Parents should discuss diagnosis and timing with a paediatric cardiologist promptly, as early specialist planning is now central to good healthcare practice for these conditions.

Congenital heart diseases (CHDs) are heart conditions that are present at birth and can affect the structure and function of a child’s heart. While some defects may be mild and require only monitoring, others can require complex cardiac procedures or surgery during infancy.

To help parents better understand congenital heart diseases and the treatment options available, Lyfboat spoke with Dr Muthu Jothi, senior consultant paediatric cardiac surgeon at Apollo Hospitals in New Delhi, India. With more than 32 years of experience, including nearly a decade of training in the UK, Dr Jothi specialises in the surgical treatment of congenital heart diseases in children.

In this interview, he explains some of the commonly seen congenital heart conditions, when treatment may be required, and how advances in diagnosis and cardiac surgery have changed outcomes for children.

Lyfboat: What are congenital heart diseases?

Dr Muthu Jothi: Congenital heart diseases are heart conditions that are present at birth. They affect the structure of the heart and can range from relatively mild defects to more complex conditions requiring early intervention.

Some children may have few or no symptoms initially, while others may require treatment during infancy. The treatment approach depends on the specific heart defect, its severity, and the child’s overall condition.

Lyfboat: What are some of the most common congenital heart diseases you treat in children?

Dr Muthu Jothi: There are several types of congenital heart diseases. Some of the conditions we commonly see include atrial septal defect (ASD), ventricular septal defect (VSD), tetralogy of fallot (TOF), single ventricle defects, and transposition of the great arteries (TGA).

Each condition is different, so the timing and type of treatment also vary.

Lyfboat: Let’s start with atrial septal defect. What is ASD and how is it treated?

Dr Muthu Jothi: An atrial septal defect, or ASD, is a hole between the two upper chambers of the heart, called the atria.

Generally, an ASD is not an emergency. In many cases, the defect can be closed using a device in a catheterisation laboratory without open-heart surgery.

However, larger ASDs may require surgical closure. Surgery is typically considered before the child reaches school age, depending on the individual case.

Lyfboat: How is a ventricular septal defect different from an ASD?

Dr Muthu Jothi: A ventricular septal defect, or VSD, is a hole between the two lower chambers of the heart, known as the ventricles.

VSDs can sometimes be more significant because the defect can cause excessive blood flow between the heart and lungs. This may increase the risk of problems such as pneumonia.

The timing of treatment depends on factors such as the size and location of the VSD.

Some small VSDs may close naturally and can be monitored. Larger VSDs may require early surgical intervention.

Lyfboat: What is tetralogy of fallot, or TOF?

Dr Muthu Jothi: Tetralogy of fallot is a congenital heart condition involving a hole in the heart along with an obstruction in the blood vessel leading to the lungs.

Children with TOF can have reduced oxygen levels and may appear blue, which is why they are sometimes referred to as “blue babies”.

In most cases, surgery is performed relatively early, often around 2–3 months of age, to correct the condition.

TOF patients require long-term follow-up. However, according to Dr Jothi, children who undergo successful treatment can go on to lead normal lives and may not require ongoing medication.

Lyfboat: What is a single ventricle defect?

Dr Muthu Jothi: A single ventricle defect is a rare and complex congenital heart condition in which there is only one functional ventricle.

Treatment is generally performed in stages. The surgical procedures are designed to bypass the heart and direct blood from the body toward the lungs for oxygenation.

These children require lifelong follow-up and medication. However, with appropriate treatment and ongoing care, they can live for many years and maintain near-normal lives.

Lyfboat: What is transposition of the great arteries?

Dr Muthu Jothi: Transposition of the great arteries, or TGA, is a condition in which the two major arteries leaving the heart (the aorta and pulmonary artery) are reversed.

A surgical procedure known as the arterial switch operation is performed to correct the problem. The surgery is generally carried out within the first few months of life.

One of the technically demanding aspects of the procedure is repositioning the coronary arteries correctly. With successful surgery, children can be expected to lead normal lives.

Lyfboat: How have advancements in technology changed the treatment of congenital heart disease?

Dr Muthu Jothi: There have been significant advances in both the diagnosis and treatment of congenital heart diseases.

One important development is antenatal echocardiography, which allows certain heart conditions to be detected while the baby is still in the womb.

Early diagnosis can help doctors and parents prepare for treatment and can contribute to better surgical planning and outcomes.

There have also been major advances in paediatric cardiac surgery. Today, modern techniques allow surgeons to operate on newborns and even babies weighing as little as 700 grams.

Lyfboat: What does early diagnosis mean for children with congenital heart disease?

Dr Muthu Jothi: Early diagnosis gives the medical team an opportunity to understand the heart condition before treatment is required and plan the appropriate course of care.

With improvements in diagnosis, surgical techniques, intensive care and follow-up, the overall prognosis for children with congenital heart diseases has improved considerably over the past few decades.

Lyfboat: What would you like parents of children with congenital heart disease to know?

Dr Muthu Jothi: Congenital heart disease includes many different conditions, and every child is different. Some defects may require observation, while others need catheter-based treatment or surgery.

Advances in paediatric cardiology and cardiac surgery have significantly improved the outlook for children with congenital heart disease. Appropriate diagnosis, timely treatment and long-term follow-up are important parts of managing these conditions.

Congenital heart disease treatment: What parents should know

Congenital heart diseases range from relatively simple defects such as some ASDs and small VSDs to complex conditions such as single ventricle defects and TGA. The treatment approach depends on the specific defect and the child’s individual medical condition.

As Dr Muthu Jothi explains, advances such as antenatal echocardiography, modern surgical techniques and improved paediatric cardiac care have changed the way congenital heart diseases are diagnosed and treated.

Parents should discuss their child’s diagnosis, treatment options and timing of intervention with a qualified paediatric cardiologist or paediatric cardiac surgeon.

About Dr Muthu Jothi

Dr Muthu Jothi is a senior consultant paediatric cardiac surgeon at Apollo Hospitals, New Delhi, with more than 32 years of experience. He underwent nearly a decade of training in the UK before returning to India and specialises in the treatment of congenital heart diseases and complex cardiac conditions in children.