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The normal heart is a pump made of muscle tissue. It's about the size of your fist. The heart has four chambers. The two upper ones are the atria, and the lower two are the ventricles. Four heart valves open and close to keep the blood flowing in one direction as it's pumped through the heart. The four heart valves are:

Each valve has a set of "flaps" (also called leaflets or cusps). The mitral valve normally has two flaps; the others have three. Dark bluish (oxygen-poor) blood returns to the heart after circulating through the body. It flows to the heart through veins and enters the right atrium. This chamber empties blood through the tricuspid valve into the right ventricle. The right ventricle pumps blood under low pressure through the pulmonary valve into the pulmonary artery. From there the blood goes to the lungs, where it gets fresh oxygen. Oxygen-rich blood is bright red. Now the blood returns to the left atrium. From there it passes through the mitral valve and enters the left ventricle.

The left ventricle pumps the red, oxygen-rich blood through the aortic valve and into a large artery called the aorta. The aorta takes blood from the heart to the rest of the body. The blood pressure in the left ventricle is the same as in the arm. While passing through the body, oxygen in the blood is distributed to the tissues. The cycle repeats as the blood flows back to the right atrium.

Congenital heart defects (or disease) (CHD) is defined by the medical profession as “a gross structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance. Statistics show that over 50% of all CHDs are in the form of VSD (ventricular septal defects), ASD (atrial septal defects) and PDA (patent ductus arteriosus). Depending upon the severity, these CHDs at birth can be categorized into 3 groups: severe, moderate and mild categories. Severe cases including all large and critical VSD (ventricular septal defects), ASD (atrial septal defects) and PDA (patent ductus arteriosus), which require intervention early in life. Moderate cases are those that require expert care, but less intensive compared to the severe cases. Mild cases are asymptomatic and often undergo spontaneous resolution.

Studies across geographic and ethnic groups find constant prevalence of CHD: approximately 7-9 per 1000 live births carry CHDs. In China, around 150,000 babies are born each year with CHD and about 60% of them being various types of VSD, ASD and PDA. In addition, an estimated 4 million adults carry untreated VSD, ASD and PDA.

According to the American Heart Association, heart defects accounted for 31.4% of all birth defect related deaths in 1992. It was estimated that 300,000 children under age 21 would have congenital cardiovascular disease by 1996; 38% of them would have one or more surgical procedures. There are approximately one million people alive with congenital heart defects today in the US.

The treatment of CHD depends on the type and severity of the defect. Other factors include the patient’s age, size, and general health. Treatment can be simple or very complex. Some can be treated with medications and are monitored by their doctor. Others may need surgery.

The following medications are now commonly used to help the heart work better and lessen symptoms:

Digoxin is thought to improve heart function and can keep the heartbeat regular.
Diuretics treat the buildup of fluid in the heart and body.
ACE inhibitors decrease the work the heart has to do and may help remodel the heart and blood vessels to work more efficiently.
Beta-blockers slow the heart rate and lower blood pressure to decrease the workload on the heart.
Inotropes strengthen the heart's pumping ability.
Prostaglandin E1 is used to keep the ductus arteriosus open in some defects until corrective surgery can be performed. This improves blood flow and oxygen levels until the defect is corrected. The ductus arteriosus normally closes within a few days after birth.

Doctors can correct some CHDs during cardiac catheterization. These are called catheter-based procedures or interventions. They can be used instead of open-heart surgery, which is a major operation. A catheter is inserted through blood vessels in the patient’s groin. It is then threaded to the heart where some holes in the interior walls of the heart can be fixed, a patent ductus can be closed, and narrow valves and blood vessels can be opened up. In treating VSD, ASD and PDA, transcatheter intervention has proven to be the most effective, least traumatic and safest procedure compared to other procedures, with minimal side effects and hospital time and fastest recovery.

AN open-heart surgery may be needed if the defect cannot be repaired using a catheter-based procedure. Some surgeries repair the defect completely. Other surgeries improve the patient’s health but do not completely repair the defect. Open-heart surgeries that may correct the defect include:

Sometimes, open-heart surgeries can improve the function of the health but do not repair the problem.

Babies born with multiple defects that are too complex to repair may need a heart transplant. In this procedure, the child's heart is replaced with a healthy heart that has been donated.