When to repair an asymptomatic partial A-V canal

  Dear Doctor,
        My son was diagnosed at four months of age as having a partial
  A-V canal and aortic stenosis.  He is now 18 months old and is healthy and gaining and growing well and has not had any problems.  He was seen at one year and is not scheduled to be seen again until age two.  We have heard conflicting information from two different cardiologists as to the best time to repair the canal.  One seemed to think that waiting as long as possible, maybe even until teen years, as long as there was no problem was the best option.  The other said that he should be repaired by age four reguardless of if he is still doing well.  Is there a best time to do a repair if all is going well?  Thank you for your time.
                               Sincerely,
                               Lori
  
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Dear Lori
The answer to your question is complex. Complete AV canals should be fixed early, usually by the age of six months. The timing of surgical correction of partial AV canal is less well defined; this applies also to timing of surgery for aortic stenosis. In large part, the timing of surgery depends on presence or absence of symptoms, associated cardiac and medical disorders, and the results of tests such as echocardiograms and cardiac catheterizations. Especially with congenital heart disease, care must be individualized. If you would like to be evaluated at the Cleveland Clinic, we would be happy to see you.
I hope this has been useful. Good luck.
Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a pediatric cardiologist.