Atrial Septal Defect Repair

Atrial Septal Defect (ASD) is a hole between the two upper chambers of the heart that allows oxygenated and deoxygenated blood to mingle. Over time, this requires the heart to work harder. According the the Cleveland Clinic this can cause congestive heart failure and pulmonary hypertension, which is high blood pressure in the lungs. ASD is present from birth and is the third most common heart defect. Many ASDs are diagnosed at birth, but some aren't discovered until adulthood. For proper diagnosis and treatment, you need to see a skilled cardiologist.

Instructions

Diagnosing and Treating Infant ASD

• 1

  A technician will inspect your prenatal ultrasound. According to Dr. Thomas Merino at Temple University, the atrial chambers of the heart begin to separate in the second month of gestation. The heart is one of the first things an ultrasound technician will focus on. Any hole in the atrial septum may close during pregnancy. The hole poses no problem to the unborn child who gets all oxygen through the umbilical cord. But any child who shows a hole before birth will receive additional testing as soon as he is born.

• 2

  If an ASD is suspected a pediatric cardiologist will order extra tests for the newborn. Merck recommends using both X-ray and an echocardiogram to get a good three- dimensional picture of the heart.

• 3

  The pediatric cardiologist will measure the image of the hole. Merck reports that most infants with a hole less than 3 mm require no surgery. Most of these small defects spontaneously close as the child develops and will disappear by the age of 18 months. But these children require frequent monitoring. Holes that are between 3 mm and 8 mm may close, but require more careful imaging. If the hole doesn't close, surgery must be performed. Any holes larger than 8 mm pose a significant risk to the child and are too big to heal without help. These ASDs require surgery.

• 4

  There are two ways to close an ASD. A pediatric cardiothoracic surgeon can go into the heart through one of the major arteries and suture the hole closed; this stops the mixture of blood immediately. The other method is to place a patch over the hole. According to the manufacturer, the patch slows the flow of blood between the two atrial chambers and encourages the growth of heart tissue over the patch, sealing the hole over time. Because so many heart defects in infants require surgery, many pediatric cardiologists are also pediatric cardiothoracic surgeons.

Adult Diagnosis and Treatment of ASD

• 5

  An adults may live out most of her life with a hole between the atrial chambers of her heart. Over time, this additional stress on the heart will show. According to the Cleveland Clinic, she will become fatigued and out of breath easily. She may develop congestive heart failure or a blood clot. It is important to discuss any changes in your energy level with your general practitioner.

• 6

  A cardiologist will order a variety of tests for the heart. The Cleveland Clinic recommends heart catheterization to measure the pressure in both atrial chambers and an angiogram to look at the health of the arteries feeding the heart muscle in addition to X-rays and echocardiograms. Besides measuring the size of the hole, these tests also look for any damage the undiagnosed ASD may have caused.

• 7

  Unlike infants, an adult with an ASD has virtually no chance of the hole closing spontaneously. The hole must be closed surgically, usually by a cardiothoracic surgeon. According to the University of Southern California, repairing an ASD is a very safe and effective procedure. Most adults are back to full function in less than three weeks. As in infants, the ASD can be closed with either sutures or a patch.

• 8

  Treat any additional heart damage. In some cases, congestive heart failure, blood clots, or valve damage may have already occurred by the time the ASD is diagnosed. After the repair of the hole, additional treatment, including valve replacement, may be necessary. A cardiologist helps the patient outline a plan to bring the heart back to good health.