One in 100 babies is born with congenital heart disease, an abnormality of the heart that occurs as it develops. Until recently, heart defects were a grim diagnosis for newborns and their families. But in the past two decades, thanks to surgical advances, 98% of those born with heart defects will now survive to adulthood.
In welcome news, patients born with congenital heart disease now have access to congenital cardiac specialists here in White Plains, as Montefiore Pediatric and Adult Congenital Heart Disease specialists are now seeing patients at 33 Davis Ave.
In 2010, for the first time ever, there were more adults than children living with congenital heart disease in the United States. Due to their improved lifespan, there is a new and unprecedented patient population of adults living with congenital heart disease.
While cardiologists are adept at managing care for heart disease occurring in adulthood, there are new challenges associated with managing any of the 20 congenital heart conditions, each with its own complications. Surgery in childhood is not a permanent fix: Valves can narrow; connections can fail; sutures can weaken. And as the heart matures, issues such as arrythmias or heart failure may develop.
Proper care for these patients requires a sophisticated approach. I work with a team of congenital heart disease surgeons, imaging specialists, cardiac interventionists, electrophysiologists, and other cardiologists at Montefiore and White Plains Hospital to support these patients in several areas, including:
- Heart-healthy lifestyle. The same advice for warding off adult-onset heart disease — eat a healthy diet, exercise regularly, and monitor your weight and blood pressure — applies even more to patients managing a congenital condition. Their hearts are already under stress, so anything raising their risk for hypertension, coronary artery disease, or similar conditions is something to avoid. We help these patients develop and maintain that healthy, preventive lifestyle.
- Starting a family. Women with congenital heart disease often worry that they will pass their condition on to their babies. While that risk is about five times higher, it’s still a low risk in the broad sense. Early detection can further dispel anxiety. As part of the Hospital’s lifelong congenital heart disease care, our maternal/fetal medicine specialists team up with OBs and cardiologists from the start. If an anatomy scan in utero detects an issue, patient education on the plan of action begins immediately. Fear always arises from the unknown. When our patients have an understanding of each step, it becomes less scary. We reassure them that we make every effort, and have every expectation, that everything will be okay.
- Upkeep and maintenance. The team and I can evaluate a patient’s past surgeries, ensure everything is “ticking” as it should, and address issues that arise over time. When surgical heart repairs need a refresh or some upkeep, the procedures can almost always be done in the Hospital’s cardiac catheterization lab. This minimally invasive approach requires a one-night stay, with far less recovery time than open-heart surgery. We can place stents to open up arteries that have been narrowed, place devices to close residual holes, and put in transcatheter valves – minor adjustments that can relieve stress on the heart and help keep it healthy for years to come.
Our Pediatric Specialty Center also offers pediatric gastroenterology services, and the Hospital plans to have additional subspecialties join our location in the near future.
Dr. Daphne Hsu is Director of the Montefiore Einstein Adult Congenital Heart Disease Program and a Professor of Pediatrics and Medicine at the Albert Einstein College of Medicine. For an appointment, call 914-849-KIDS (5437).