Treatments for Atrioventricular Canal Defect in Children

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Contact the Complex Biventricular Repair Program

At Boston Children's Hospital, once we've identified your child's heart condition, we're able to begin the process of treating him, so that we may ultimately return him to good health.

Specific treatments for atrioventricular canal defect depend on the extent of the disease—which can range from a single defect to a full combination of defects (complete). AV canal is almost always treated by surgical repair of the defects. Medications may be helpful and improve symptoms until the operation is performed.

Age for surgery

Most children undergo surgery by the age of three to six months. Children with Down syndrome may develop symptoms earlier than other children, and may need to have surgery at an earlier age.


Treatments may include:

  • medical management
    • Infants may become tired when feeding, and may not be able to eat enough to gain weight. Nutritional support from more concentrated breast milk or formula gives the baby more calories or other forms of nutritional assistance
    • diuretics, such as Lasix, helps the kidneys remove excess fluid from the lungs and body
    • ACE (angiotensin-converting enzyme) inhibitors, such as Captopril or Enalapril, help the heart pump blood forward into the body
    • digoxin helps strengthen the heart muscle, enabling it to pump more efficiently
  • surgical procedure
    • The atrioventricular valves (tricuspid and mitral valves) are repaired to create two separate functioning valves, one for each side of the heart.
    • The ASD and VSD are closed with patches over the holes.
    • A heart-lung bypass machine will do the work of the heart and lungs during surgery.

The methods used to repair AV canal have improved greatly in the past two decades, and the operation has a high likelihood of success.


At home: caring for your child after surgery for AV canal


After your baby's operation and hospital stay (usually five to seven days), he'll need to be followed by a pediatric cardiologist, who will offer recommendations for post-operative follow-up care, including:

  • wound care while your baby is healing
  • a nutritional program to encourage weight gain
  • an oral hygiene program to prevent infection
  • an appropriate exercise regimen to build body mass and achieve fitness

As your baby recovers and grows, be sure to follow a regular program of well-baby/well-child checkups.

As he grows: your child's long-term outlook

Many children who've had an AV canal repair will live healthy lives. Activity levels, appetite and growth typically return to normal in most children. Some children will still have some degree of mitral or tricuspid valve abnormality or leakage after surgery, which may require another operation in the future. AV canal patients will need lifelong monitoring (some will need medication), since they will always be at some risk for arrhythmias, infections, heart failure or stroke.

Your cardiologist will help you create a long-term care program as your baby matures into childhood, the teen years and even adulthood. Most people who have had congenital heart disease repair will have an ongoing relationship with their cardiologist. We will prevent and treat complications, and will advise on daily-life issues such as activity levels, nutrition and any precautions related to becoming pregnant.

Children with Down syndrome will benefit from special programs that not only enhance mental and physical development, but that also understand the implications of the heart issues that Down syndrome children often cope with. Your child's doctor can help you locate such programs in your community.

Coping and support

At Boston Children's, we understand that a hospital visit can be difficult, and sometimes overwhelming. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit our Center for Families for all you need to know about:

  • getting to Boston Children's
  • accommodations
  • navigating the hospital experience
  • resources that are available for your family

In particular, we understand that you may have a lot of questions if your child is diagnosed with AV canal. How will it affect my child long term? What do we do next? We can connect you with a number of resources to help you and your family through this difficult time, including:

  • patient education: From the office visit to pre-op to the recovery room, our nurses will be on hand to walk you through your child's treatment and help answer any questions you may have—How long will I be separated from my child during surgery? What will the operating room be like? They'll also reach out to you by phone, continuing the care and support you received while at Children's.
  • parent-to-parent: Want to talk with someone whose child has been treated for AV canal? We can often put you in touch with other families who've been through the same procedure that you and your child are facing, and who will share their experiences.
  • faith-based support: If you're in need of spiritual support, we'll connect you with the Children's chaplaincy. Our program includes nearly a dozen clergy— representing Protestant, Jewish, Muslim, Roman Catholic and other faith traditions—who will listen to you, pray with you and help you observe your own faith practices during your hospital experience.
  • social work:  Our social workers and mental health professionals have helped many families in your situation. We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial difficulties.
  • As your child reaches adulthood, you'll want him to know about the Boston Adult Congenital Heart (BACH) and Pulmonary Hypertension Service. Children's is a founding institution of BACH—an international center for excellence, providing long-term inpatient and outpatient care and advanced therapeutic options as needed for congenital heart disease patients as they reach and progress through adulthood.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944