Atrial Septal Defect (ASD)
Atrial septal defect (ASD) is a form of congenital heart defect that enables blood flow between the left atrium (with high oxygen content) and right atrium (with low oxygen content) via the interatrial septum. The interatrial septum is the tissue that divides the right and left atria. Without this septum, or if there is a defect in this septum, it is possible for blood to travel from the left side of the heart to the right side of the heart, or vice versa. Irrespective of interatrial communication bi-directions, this results in the mixing of arterial and venous blood and may cause shunting.
Individuals with ASD are at an increased risk for developing a number of complications including:
• Pulmonary overcirculation
• Heart failure
• Atrial fibrillation (in adults)
• Pulmonary hypertension
People with small-to-moderate-sized defects may show no symptoms, or not until middle age or later. Others have the following symptoms:
• Frequent respiratory infections in children
• Difficulty breathing (dyspnea)
• Shortness of breath with activity
• Sensation of feeling the heart beat (palpitations ) in adults
Tests performed to diagnose ASD include:
• Chest x-ray
• Echocardiography (ultrasound of the heart)
• Doppler study of the heart
• Transesophageal echocardiography (TEE)
• Cardiac catheterization
• Coronary angiography (for patients over 35 years old)
• MRI of heart
• Electrocardiogram (ECG or EKG)
ASD may not require treatment if there are few or no symptoms, or if the defect is small. Surgical closure of the defect is recommended if the atrial septal defect is large, the heart is enlarged, or symptoms occur.
An ASD closure device (ASD device) is used to close the interatrial septum that causes the atrial septal defect (ASD). The ASD device is moved through a catheter or using open heart surgery to the location of the heart wall defect. Once in the correct location, the ASD closure device is allowed to expand its shape to spread out to each side of the hole. The device will remain in the heart permanently to stop the abnormal flow of blood between the two atria chambers of the heart. Examples of ASD closure device include Amplatzer® Septal Occluder System and the HELEXTM Septal Occluder.
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