Descripción general
La atresia pulmonar con defecto del tabique ventricular es un problema cardíaco presente al nacer. Eso significa que es un defecto cardíaco congénito.
En el caso de este tipo de atresia pulmonar, la válvula que se encuentra entre el corazón y los pulmones no está completamente formada. A esta válvula se la conoce como válvula pulmonar. La sangre no puede fluir de la cavidad inferior derecha del corazón o ventrículo derecho a los pulmones. En la atresia pulmonar con defecto del tabique ventricular, también hay un agujero entre las dos cavidades de bombeo del corazón.
El defecto del tabique ventricular permite que la sangre entre a la cavidad inferior derecha del corazón y salga de ella. Es posible que un poco de sangre también fluya a través de una abertura natural conocida como conducto arterial. El conducto arterial, normalmente, se cierra al poco tiempo del nacimiento. Pero con medicamentos, se lo puede mantener abierto.
La arteria pulmonar y sus ramas pueden ser muy pequeñas o inexistentes en el caso de los bebés con atresia pulmonar. Si faltan estos vasos sanguíneos, se forman otras arterias en la arteria principal del cuerpo o aorta. Estas contribuyen a proporcionar flujo sanguíneo a los pulmones. Se las conoce como arterias colaterales aortopulmonares principales.
La atresia pulmonar con defecto del tabique ventricular es una afección que pone en riesgo la vida. Un bebé con atresia pulmonar no recibe oxígeno suficiente. Se necesitan medicamentos y uno o más procedimientos o cirugías para mejorar el flujo sanguíneo y reparar el corazón.
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Síntomas
Symptoms of pulmonary atresia with ventricular septal defect, also called PA-VSD, may appear at birth or very soon after. They can include:
- Blue or gray skin. This change may be harder or easier to see depending on skin color.
- Fast breathing or shortness of breath.
- Tiredness.
- Poor feeding.
When to see a doctor
Pulmonary atresia with ventricular septal defect, also called PA-VSD, is typically found during pregnancy or soon after birth. If your baby has symptoms of this condition after birth, call a healthcare professional right away.
Causas
The cause of pulmonary atresia with ventricular septal defect, also called PA-VSD, is not clear. Most congenital heart conditions happen during the first six weeks of pregnancy. The major blood vessels that run to and from the heart also begin to grow at this time. This is when a congenital heart defect such as pulmonary atresia may occur.
In PA-VSD, the pulmonary valve isn't fully formed. There also is a hole in the heart called a ventricular septal defect. The hole lets blood flow into and out of the right lower heart chamber. Some blood also may flow through a natural opening called the ductus arteriosus. The ductus arteriosus usually closes soon after birth. But medicines can keep it open.
In babies with pulmonary atresia, the lung arteries can be very small. Or they may be missing. If the blood vessels are missing, other vessels form on the body's main artery, called the aorta. These new vessels help send blood to the lungs. They are called major aortopulmonary collateral arteries, also called MAPCAs.
Factores de riesgo
It's not clear what increases the risk of pulmonary atresia with ventricular septal defect. Possible risk factors for congenital heart conditions in general may include:
- Smoking. If you smoke, quit. Smoking during pregnancy or being around cigarette smoke increases the risk of some congenital heart conditions.
- Alcohol use. Drinking alcohol during pregnancy may increase the risk of heart conditions in the baby.
- Some medicines. Some medicines taken during pregnancy may increase the risk of congenital heart conditions. These include lithium (Lithobid) for bipolar disorder and isotretinoin (Claravis, Myorisan, others), which is used to treat acne. Talk with your healthcare team about the medicines you take.
- Genetics. Changes in some genes may affect how a baby's heart forms. For example, people with Down syndrome are often born with heart conditions.
- Diabetes. Having type 1 or type 2 diabetes during pregnancy may change how a baby's heart forms. Diabetes that develops during pregnancy is called gestational diabetes. It typically doesn't increase a baby's risk of congenital heart conditions.
- Rubella, also called German measles. Having rubella during pregnancy can change how a baby's heart forms. A blood test can be done before pregnancy to see if you're immune to rubella. If you're not, a vaccine is available.
Aug. 20, 2024