OUTLINE
24 November 2021

How to repair a baby’s broken heart

Some babies are born with a rare disorder in which only one of the lower chambers of their heart works properly. These single-ventricle defects (SVDs) can be managed through a complex series of operations.

Benjamin Plackett⁰

Benjamin Plackett
1. Benjamin Plackett is a science journalist in Dubbo, Australia.
View author publications

You can also search for this author in PubMed Google Scholar

You have full access to this article via your institution.

Download PDF

Healthy heart circulation

Deoxygenated blood (blue) arrives in the heart’s right atrium from two veins — the superior and inferior vena cava and is then passed through the tricuspid valve to the right ventricle, which pumps it to the lungs. Oxygenated blood (red) from the lungs travels through the pulmonary veins to the heart’s left atrium, then through the mitral valve to the left ventricle, which pumps the blood out to the rest of the body.

Graphic showing the basic anatomy and function of the human heart — Infographic: Alisdair Macdonald

Three kinds of defect

The anatomy of each SVD differs, but they all result in a mix of oxygenated and deoxygenated blood being pumped to the body and lungs. This means that vital organs don’t get enough oxygen.

Graphic illustrating three kinds of heart defect — Infographic: Alisdair Macdonald

A solution in stages

SVDs are treated with a sequence of three operations². Together, these surgeries ensure that the deoxygenated blood returning from the body bypasses the heart and goes straight to the lungs. The heart is then left to pump only oxygenated blood — getting rid of the problem of mixed blood.

Graphic illustrating the three surgical procedures for SVDs — Infographic: Alisdair Macdonald

Comorbidities are common

Complications: Children born with SVDs can live into their 30s and 40s, but they have a significantly higher chance of experiencing other diseases as compared with healthier adults³^–⁷.

Bar chart showing relative risk that adults with SVDs will experience other diseases — Infographic: Alisdair Macdonald

In utero surgery

Surgeons have begun to pioneer procedures to start treatment from within the womb.

Graphic illustrating featl balloon atrial septostomy — Infographic: Alisdair Macdonald

Nature 599, S22-S23 (2021)

doi: https://doi.org/10.1038/d41586-021-03518-y

This article is part of Nature Outline: Single-ventricle heart defects, an editorially independent supplement produced with the financial support of third parties. About this content.

References

Fixler, D. E. et al. Circulation 121, 644–650 (2010).
Article PubMed Google Scholar
Rao, P. S. Children 8, 441 (2021).
Article PubMed Google Scholar
Pujol, C. et al. J. Clin. Med. 9, 4085 (2020).
Article Google Scholar
Madariaga, A. G. et al. J. Clin. Endocrinol. Metab. 99, 923–931 (2014).
Article PubMed Google Scholar
Gandjour, A. et al. PLoS ONE 15, e0231375 (2020).
Article PubMed Google Scholar
Busch, M. A. et al. Bundesgesundheitsbl. 56, 656–660 (2013).
Article Google Scholar
GBD 2017 Cirrhosis Collaborators Lancet Gastroenterol. Hepatol. 5, 245–266 (2020).
Article PubMed Google Scholar
Liu, Y. et al. Int. J. Epidemiol. 48, 455–463 (2019).
Article PubMed Google Scholar