What is the definitive treatment for AVSD?

• A. Surgical correction is the definitive treatment
• B. Medical therapy only is sufficient
• C. Observation is all that is needed
• D. Heart transplant is first-line therapy

Answer: (A)

Surgical correction is the definitive treatment for AVSD. AVSD is a congenital defect where the atrioventricular septum and valves are abnormal, creating a large shunt and potential valve regurgitation. While medical therapy can help manage symptoms temporarily, it does not fix the underlying anatomy. Observation alone allows ongoing left-to-right shunting and can lead to worsening heart failure or pulmonary vascular disease.

The goal of surgery is to anatomically repair the defect: close the atrial and ventricular septal defects and reconstruct or repair the single or abnormal AV valve so there are two functional, separate AV orifices. This eliminates the abnormal communication and reduces regurgitation, addressing the root cause rather than just the symptoms. In most cases, repair in infancy yields good outcomes.

Heart transplant is not a first-line option for AVSD, and medical therapy or observation does not provide a durable cure.