Yes, Most women with congenital heart disease can safely have children but pregnancy carries real risks including arrhythmia, heart failure and stroke that vary significantly by defect type and repair history. It requires specialised care from a team including a cardiologist and maternal-fetal medicine specialist and that conversation needs to start before conception not after a positive test arrives.

“I’ve seen women with complex congenital heart disease carry pregnancies to term and do well and I’ve seen women with seemingly simple repaired defects run into problems nobody anticipated because nobody did a proper pre-conception cardiac evaluation before they conceived,” says Dr. Prashant Bobhate, Pediatric Cardiologist in Mumbai, India.

Pregnancy puts the cardiovascular system under a sustained haemodynamic load and a heart already managing abnormal anatomy handles that load very differently from a structurally normal one.

• Blood volume surge: Pregnancy increases blood volume by 40 to 50 percent and a heart with limited functional reserve can decompensate rapidly under that sustained demand even if it was compensating adequately before conception.
• Arrhythmia risk: The haemodynamic and hormonal changes of pregnancy lower the arrhythmia threshold and atrial flutter, SVT and ventricular arrhythmias can emerge in women who had no rhythm history whatsoever before conceiving.
• Pulmonary hypertension: Women with pulmonary arterial hypertension face the highest maternal mortality risk of any cardiac condition in pregnancy because systemic vasodilation against fixed pulmonary vascular resistance can deteriorate rapidly and catastrophically.
• Fontan circulation: The passive pulmonary blood flow that sustains a Fontan depends on venous pressure gradients that pregnancy disrupts and obstetric outcomes in Fontan patients need the most experienced multidisciplinary team available.

Every woman with a congenital heart diagnosis considering pregnancy deserves a full structural and functional assessment and congenital heart disease evaluation before conception maps current anatomy, ventricular function and pulmonary pressures before any pregnancy planning moves forward.

Planned, monitored and never managed alone by a single specialist.

• Pre-conception counselling: A cardiac assessment before attempting pregnancy establishes the current baseline of ventricular function, pulmonary pressure and rhythm status so any changes during pregnancy can be measured against something real rather than guessed at.
• Medication review: Several cardiac medications including warfarin, ACE inhibitors and some antiarrhythmics carry real fetal risk and switching to pregnancy-safe alternatives before conception is far safer than scrambling to change them after a positive test.
• High-risk obstetric co-management: A maternal-fetal medicine specialist needs to be part of the team from the start because delivery timing, mode of delivery and anaesthetic approach all have cardiac implications that require both teams aligned well before the moment arrives.
• Delivery planning: Women with significant CHD need delivery at a centre with cardiac anaesthesia, adult congenital cardiology and a cardiac ICU on site because the haemodynamic shift immediately after delivery is one of the highest-risk moments in the entire pregnancy.

Parents wanting to understand the long-term journey of congenital heart care should also explore surgery costs, as treatment planning often begins early and financial preparation plays an important role in managing cardiac care from childhood onward

A woman with congenital heart disease who wants to have children needs a cardiologist who understands what her specific anatomy does under the haemodynamic load of pregnancy, can advise on medication changes before conception and can coordinate with the obstetric team across the full nine months rather than showing up only when something goes wrong. Dr. Prashant Bobhate has spent over 12 years managing adult congenital heart disease including pre-conception counselling and pregnancy planning for women with complex repaired and unrepaired cardiac conditions at the Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital.

• Congenital Heart Defects, MedlinePlus, U.S. National Library of Medicine — https://medlineplus.gov/congenitalheartdefects.html
• Congenital Heart Defects, National Heart Lung and Blood Institute — https://www.nhlbi.nih.gov/health/congenital-heart-defects

Around 240,000 babies are born with congenital heart disease in India every year, roughly one in every 100 newborns, making it the leading cause of birth defect-related deaths and accounting for nearly 10 percent of all infant deaths in the country. The defects are present. The surgical solutions exist. The gap that kills children sits between those two facts and in 2026 that gap is still far wider than it should be.

“The numbers are not abstract to me. Every year tens of thousands of Indian children who could have been saved with a timely intervention aren’t and the reason is almost never that the surgery was too difficult. It’s that nobody found them early enough or the family couldn’t access the right centre in time” says Dr. Prashant Bobhate, Pediatric Cardiologist in Mumbai, India.

It creates a deliberate right-to-left shunt at the level of the great vessels that allows the overloaded right ventricle to decompress directly into the aorta rather than continuing to push against a pulmonary vascular resistance it can no longer overcome.

• Right ventricular decompression: The shunt allows blood to bypass the high-resistance pulmonary circulation entirely which immediately reduces the pressure load on a right ventricle that was heading toward failure and gives the chamber a chance to recover function it was rapidly losing.
• Maintains cardiac output: A failing right ventricle in severe PH can no longer maintain adequate systemic circulation and the Potts shunt preserves overall cardiac output even at the cost of some arterial oxygen desaturation which is an acceptable trade-off when the alternative is right heart collapse.
• Bridge to transplant: In children who are maxed out on medical therapy and deteriorating despite everything, the Potts shunt buys enough haemodynamic stability to reach lung transplant listing criteria and survive the wait in a condition where transplant is actually still feasible.
• Transcatheter approach: India’s first successful transcatheter Potts shunt was performed at this centre using a catheter-based technique rather than open surgery which reduces the procedural risk significantly in children who are already haemodynamically fragile and couldn’t safely tolerate a sternotomy at that point in their disease.

Understanding what interventional options exist for children with severe pulmonary hypertension who have exhausted conventional medical pathways is exactly what a thorough interventional treatment for pulmonary hypertension assessment maps out before any decision gets made.

Better than a decade ago, but still nowhere near where they should be

• Better Surgical Outcomes: Leading Indian paediatric cardiac centres now achieve outcomes comparable to global standards for common congenital heart surgeries when treated early
• Delayed Diagnosis Risk: Many children reach surgery late with complications like malnutrition or pulmonary hypertension, which worsens recovery
• Ayushman Bharat Support: PM-JAY has improved affordability, but specialist care remains concentrated in limited cities
• Fetal Diagnosis Advantage: Early detection through fetal echocardiography improves outcomes by enabling timely referral before complications develop 

Parents wanting to understand why fetal cardiac detection matters should read about the importance of fetal diagnosis of critical congenital heart disease, as early detection can mean the difference between planned care and an emergency after birth.

The statistics describe a system problem. What matters to any individual family is whether the specialist in front of them has the training, the equipment and the experience to find the defect early, make the right call about timing and intervention and follow that child for as long as the heart needs watching. Dr. Prashant Bobhate has spent over 12 years managing congenital heart disease across every defect type and every level of complexity at the Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital, one of Mumbai’s leading paediatric cardiac centres with fetal echo, interventional cardiology and surgical co-management all in one place

• Saxena A. Congenital Heart Disease in India: A Status Report. Indian Pediatrics, 2018 — https://pubmed.ncbi.nlm.nih.gov/30745481/
• Global CHD Burden 1990–2021, Frontiers in Cardiovascular Medicine, 2025 — https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1522644/full

The Potts shunt is a surgically or catheter-created connection between the left pulmonary artery and the descending aorta that gives the right ventricle a pressure release valve when pulmonary hypertension has become so severe the right heart can no longer sustain it safely on its own. It doesn’t cure pulmonary hypertension.

“The Potts shunt is one of the most misunderstood procedures in paediatric pulmonary hypertension care because families hear it described as a last resort and immediately interpret that as giving up when it’s actually the opposite.” says Dr. Prashant Bobhate, Pediatric Cardiologist in Mumbai, India.

It creates a deliberate right-to-left shunt at the level of the great vessels that allows the overloaded right ventricle to decompress directly into the aorta rather than continuing to push against a pulmonary vascular resistance it can no longer overcome.

• Right ventricular decompression: The shunt allows blood to bypass the high-resistance pulmonary circulation entirely which immediately reduces the pressure load on a right ventricle that was heading toward failure and gives the chamber a chance to recover function it was rapidly losing.
• Maintains cardiac output: A failing right ventricle in severe PH can no longer maintain adequate systemic circulation and the Potts shunt preserves overall cardiac output even at the cost of some arterial oxygen desaturation which is an acceptable trade-off when the alternative is right heart collapse.
• Bridge to transplant: In children who are maxed out on medical therapy and deteriorating despite everything, the Potts shunt buys enough haemodynamic stability to reach lung transplant listing criteria and survive the wait in a condition where transplant is actually still feasible.
• Transcatheter approach: India’s first successful transcatheter Potts shunt was performed at this centre using a catheter-based technique rather than open surgery which reduces the procedural risk significantly in children who are already haemodynamically fragile and couldn’t safely tolerate a sternotomy at that point in their disease.

Understanding what interventional options exist for children with severe pulmonary hypertension who have exhausted conventional medical pathways is exactly what a thorough interventional treatment for pulmonary hypertension assessment maps out before any decision gets made.

A very specific group. Not every child with PH. Not even every child with severe PH.

• Suprasystemic RV pressure: Children whose right ventricular pressure has risen above systemic pressure on maximal combination medical therapy are the primary candidates because at that level the right heart is in imminent danger of irreversible failure and the shunt is the only intervention that immediately addresses the mechanical crisis.
• Failing on maximal therapy: A child already on triple combination PH therapy including a prostacyclin who continues to deteriorate clinically and haemodynamically is telling you the medical ceiling has been reached and the next decision is either the Potts shunt or palliative management with no bridge to anything.
• Pre-transplant stabilisation: Children being evaluated for lung transplant who are too unstable to survive the wait on medical therapy alone are given the Potts shunt to stabilise their haemodynamics long enough to get listed, wait and reach the transplant in a condition where it can actually succeed.
• Not suitable for everyone: Children with significant left heart disease, severe aortic regurgitation or unfavourable anatomy at the shunt site aren’t candidates and the decision requires detailed catheterisation data, imaging and a team that has actually performed this procedure rather than read about it.

Parents wanting to understand how severe pulmonary hypertension can progress and why options like Potts shunt may become necessary should also read about when lung transplant is needed in pulmonary hypertension.

Dr. Prashant Bobhate performed India’s first successful transcatheter Potts shunt and has over 12 years of expertise managing complex paediatric pulmonary hypertension cases at Kokilaben Dhirubhai Ambani Hospital, including advanced interventions, triple therapy management, transplant bridging, and severe cases requiring specialised multidisciplinary pulmonary hypertension care.

• Pulmonary Arterial Hypertension, National Heart Lung and Blood Institute — https://www.nhlbi.nih.gov/health/pulmonary-hypertension
• Pulmonary Hypertension, MedlinePlus, U.S. National Library of Medicine — https://medlineplus.gov/pulmonaryhypertension.html

A child’s open-heart surgery usually takes about 3 to 6 hours, although more complex procedures may take longer. During the operation, the child is placed on a heart-lung machine. After surgery, most children require 2 to 4 days in the ICU, followed by a total hospital stay of around 5 to 7 days. In more complex cases, recovery in the hospital can extend to several weeks.

“Families fixate on the duration in the waiting room and I understand why but the number that actually matters isn’t how long the surgery took it’s what the surgeon says when they come out to tell you how it went,” says Dr. Prashant Bobhate, Pediatric Cardiologist in Mumbai, India.

The anatomy underneath the diagnosis is what sets the surgical clock and two children with the same condition can have repairs of very different complexity and duration depending on what the surgeon actually encounters.

• Defect type: Simple secundum ASD or isolated VSD closures are among the shorter cardiac procedures, while complex repairs involving outflow tract reconstruction, valve work or multiple simultaneous defects add significant time under bypass that straightforward closures don’t need.
• Bypass time: The time the heart is stopped and the child is on cardiopulmonary bypass is the most clinically significant part of the duration because longer bypass times carry a higher risk of post-operative complications, and surgeons manage this carefully, not just to be efficient but because it directly affects outcomes.
• Unexpected findings: Sometimes the anatomy is more complex than the pre-operative echo suggested, an additional defect is found, a valve is more abnormal than imaging showed or tissue quality requires a different repair approach and all of these extend theatre time in ways nobody could predict before opening the chest.
• Redo surgery: A child who has already had one cardiac operation and needs a second carries scar tissue, adhesions and altered anatomy from the first repair and dissecting through that safely adds significant time before the actual correction even begins.

Understanding what a child’s specific defect requires in terms of surgical repair and what the recovery looks like afterwards is exactly what a thorough congenital heart disease consultation maps out before any theatre date is confirmed.

The hardest hours most cardiac families will ever sit through.

• Bypass team updates: Most centres provide a liaison nurse or team member who updates the waiting family at key surgical milestones and if your centre doesn’t offer this ask specifically before admission day because waiting six hours in silence is genuinely harder than it needs to be.
• Why it’s taking longer: A surgery running over the estimated time doesn’t automatically mean something has gone wrong and it’s often the surgeon being more careful or finding something that needed extra attention rather than an emergency and the team should be telling you which it is.
• Anaesthesia and bypass monitoring: While the surgeon works a separate team manages the bypass circuit, the anaesthesia, the child’s temperature, blood pressure and organ perfusion continuously and the size of the team in that theatre is something most families never see and would find reassuring if they did.
• Coming out of bypass: Weaning the heart off cardiopulmonary bypass and restoring normal rhythm is a distinct phase at the end of the operation that can itself take thirty minutes to an hour and families told the surgery is finishing should expect another wait before the surgeon actually appears in the waiting area.

Parents wanting to understand what the warning signs of cardiac deterioration look like in children in the days and weeks after open heart surgery should read this piece on the top 5 warning signs of pediatric heart failure, because knowing what to watch for at home is as important as understanding what happened in the operating theatre.

A family sitting in a waiting room for four hours deserves a team that keeps them informed, prepares them before the surgery for what longer theatre times might mean and doesn’t leave them alone with catastrophic imagination filling the silence. That preparation starts at the pre-surgical cardiology appointment not on the day. Dr. Prashant Bobhate has spent over 12 years preparing families for paediatric cardiac surgery across every defect type and complexity at the Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital. Escorts Heart Institute New Delhi.

• Congenital Heart Defects, MedlinePlus, U.S. National Library of Medicine — https://medlineplus.gov/congenitalheartdefects.html
• Congenital Heart Defects, National Heart Lung and Blood Institute — https://www.nhlbi.nih.gov/health/congenital-heart-defects

Most children go home within one to two days of VSD device closure and return to normal activity within one to two weeks. No chest opening, no bypass, no long ICU stay. But faster recovery doesn’t mean no recovery, and the first month after the procedure carries specific restrictions, medications, and follow-up echo requirements that need to be followed properly for the device to settle safely into position.

“Parents are often surprised by how quickly their child bounces back after device closure compared to what they were imagining open heart surgery would look like, and that’s genuinely one of the things that makes catheter-based closure the right answer when the anatomy supports it,” says Dr. Prashant Bobhate, Pediatric Cardiologist in Mumbai, India.

The first 48 hours are monitored, structured, and very different from what families imagine open-heart recovery involves because this procedure doesn’t touch the chest wall at all.

• Same day monitoring: After the procedure, the child is observed in a monitored bed for several hours to confirm the device is sitting correctly, the heart rhythm is stable, and there’s no significant residual shunting visible on the post-procedure echo before anyone talks about the ward.
• Hospital stay: Most children spend one night in the hospital after uncomplicated device closure and are discharged the following morning once the team is satisfied with the rhythm, the echo findings, and the child’s overall clinical status.
• Catheter site care: The entry point in the femoral vein or artery needs to be kept clean and dry for several days, and physical activity that strains the groin area needs to be avoided for at least a week to allow the access site to heal without complication.
• Going home medications: Aspirin for antiplatelet cover is prescribed for six months after most VSD device closures to reduce the risk of clot formation on the device surface while the heart tissue grows over it, and this medication needs to be given exactly as prescribed without gaps.

Understanding what the full picture of VSD management looks like from diagnosis through closure through long-term follow-up is exactly what a thorough ventricular septal defect assessment maps out before any intervention decision gets made.

More specific than most families expect from a catheter procedure.

• First two weeks: No running, jumping, contact sport or rough play because the device is still embedding into the septal tissue and any significant physical impact during this window carries a small but real risk of device displacement before tissue ingrowth is complete.
• Return to school: Most children can return to school within one to two weeks but need to be excused from physical education, sports and any activity involving physical contact for the full first month until the follow-up echo confirms the device is stable and well positioned.
• One month echo: This is the most important follow-up appointment in the entire post-closure period because it confirms device position, checks for residual shunting, assesses the rhythm and determines whether the antiplatelet medication continues or can be reviewed at the next visit.
• Six month review: A second echo at six months confirms complete tissue coverage of the device, checks valve function on both sides of the septum and gives the cardiologist the information needed to formally close the active surveillance phase or flag anything that needs continued monitoring.

Parents wanting to understand what cardiac warning signs look like in children in the weeks after any cardiac procedure should read this piece on top 5 warning signs of pediatric heart failure because knowing what to watch for at home is as important as knowing what happened in the catheterisation lab.

VSD device closure isn’t just the procedure on the day. It’s the echo assessment that confirms the anatomy supports a device, the catheterisation performed precisely enough that the device sits without residual shunting, and the follow-up plan that catches anything that changes in the months after. All of that in one place. Dr. Prashant Bobhate has spent over 12 years performing catheter-based VSD closures and managing the full post-procedure surveillance pathway at the Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital. Escorts Heart Institute, New Delhi. Fellowship at the University of Alberta, Canada. Over 400 children are on active cardiac therapies right now. He doesn’t hand a family a discharge summary and step back. He follows the device until the heart has made it its own.

📞 Call Now: (+91) 8080 826 898 A proper VSD assessment tells you whether device closure is anatomically possible for your child, what the procedure involves, and exactly what the recovery and follow-up plan looks like from day one through six months.

• Ventricular Septal Defect, MedlinePlus, U.S. National Library of Medicine — https://medlineplus.gov/ency/article/001099.htm
• Congenital Heart Defects, National Heart Lung and Blood Institute — https://www.nhlbi.nih.gov/health/congenital-heart-defects