Types of defects: Abnormal location of blood vessels

The two great highways in the heart are the pulmonary artery, which carries blood to the lungs to be oxygenated, and the aorta, which carries oxygenated blood to the body. Defects in the locations of these pathways can dramatically affect the circulation of blood in the body, with the result that tissues throughout the body don't get enough oxygen and nutrients to function properly.

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Transposition of the great arteries - This condition, where the locations of the pulmonary and aortic arteries are reversed, results in two--instead of one--circulatory patterns in the body accounts for approximately 10 percent of congenital heart defects. When the aorta is attached to the right ventricle instead of the left, nonoxygenated blood circulates through the body in a more or less closed loop, never flowing through the lungs to be oxygenated. Since the pulmonary artery is connected to the left ventricle instead of the right, oxygen-rich blood is pumped back to the lungs instead of to the body. When the great arteries are transposed, the tissues of the body do not get enough oxygen.

Congenitally corrected transposition of the great arteries - With this defect, not only are the locations of the arteries reversed (transposed) but so are the connections between the atria and ventricles. This second abnormal connection is, in a sense, "corrective" since the blood still flows in the appropriate direction but is being pumped by the "wrong" ventricle. Thus the left ventricle pumps to the lungs and the right ventricle pumps blood to the body via the aorta. This structural change results in the weaker of the ventricles, the right, carrying the greater workload of the heart and can potentially lead to heart failure.

Tetralogy of Fallot - This common defect, accounting for 9 to14 percent of congenital heart defects, is really four defects in combination. It features a ventricular septal defect, an obstruction to blood flow beneath the pulmonary valve, an aorta that is shifted to the right, and a thickened right ventricular wall. The net result is decreased blood flow to the lungs and the circulation of nonoxygenated blood to the body.

Truncus arteriosus - In this rare defect, the pulmonary and aortic arteries originate out of a single large artery or trunk. With a single trunk, oxygen-rich and oxygen-poor blood are mixed during circulation, resulting in some oxygen-rich blood being redirected to the lungs to be reoxygenated and some oxygen-poor blood being recirculated in the body.

Coarctation of the aorta - Coarctation is a relatively common defect accounting for 8 to 11 percent of congenital heart defects in adults. It occurs more frequently in men and is characterized by localized narrowing or constriction in the aorta. Coarctation obstructs blood flow from the heart to the body and may increase the risk of stroke and premature coronary artery disease.

Anomalous pulmonary veins - In this very rare defect, one or more of the pulmonary veins responsible for carrying oxygen-rich blood from the lungs to the heart is attached to the right side of the heart instead of the left. As a result, the right side of the heart carries an increased volume of blood and may enlarge and fail.