VATER Association

VATER is an acronym which stands for:

V  Vertebral
A  Anal atresia
C  Cardiac (heart) defects
T  Tracheoesophageal fistulas
E  Esophageal atresia
R  Renal (kidney) abnormalities
L  Limb (arms, hands, legs) abnormalities

(See below for a detailed description of VATER.) It stands for a possible associated medical condition. Not all of the associations are seen in every child with VATER. The combinations do vary from child to child. This condition is rarely inherited.

When your child was born, you may have been referred to other doctors who were specialists in the field of heart, bowel, kidney, bone or lungs for further treatment. The hand surgeon is usually the last consultant to become involved in your child’s care.

You should continue the care with the other specialists for your child’s treatment. Care for your child’s hands will be tailored. Surgery to help improve hand and arm function may or may not be recommended.

If there are linked heart defects, clearance from the heart specialist will be needed prior to surgery. Follow-up visits will be set as needed for monitoring of your child’s hand function.

Vertebral (spine or backbone)

• Scoliosis or curvature of the spine
• Extra ribs
• Hemivertebra - one side of the spine forms and other side does not

Anal atresia

• Absence of a rectum
• Imperforate anus (no opening)
• Fistulas (an abnormal passage between two body organs, such as the rectum to the vagina)

Cardiac (heart) defects

• Ventricular septal defects (opening between the two sides of the heart)

Tracheoesophageal fistulas (trachea = windpipe; esophageal = food pipe)

• Abnormal passage from trachea to esophagus

Esophageal atresia (absent or closed)

Renal (kidney) abnormalities

• Horseshoe shaped
• Underdeveloped urethra (urethra = a tube connecting the bladder to the kidney)

Limb (arms, hands, legs) abnormalities

• Hexadactyly (six fingers or toes)
• Humeral hypoplasia (underdeveloped upper arms)
• Radial dysplasia (radius size, shape and development of forearm abnormal)
• Abnormal placement of the thumb