ASD - Atrial Septal Defect Surgery  [Pediatric]

What is an atrial septal defect ?

Atrial Septal Defect is an opening in the atrial septum, or dividing wall between the two upper chambers of the heart known as the right and left atria. ASD is a congenital (present at birth) heart defect. As the fetus is growing, something occurs to affect heart development during the first eight weeks of pregnancy, resulting in an ASD.

Arial septal defects occur in 4 percent to 10 percent of all children born with congenital heart disease. For unknown reasons, girls have atrial septal defects twice as often as boys.

What causes an atrial septal defect ?

The heart is forming during the first eight weeks of fetal development. It begins as a hollow tube, then partitions within the tube develop that eventually become the septa (or walls) dividing the right side of the heart from the left. Atrial septal defects occur when the partitioning process does not occur completely, leaving an opening in the atrial septum...

What are the types of atrial septal defects ?

There are three major types of atrial septal defects : -

• Secundum atrial septal defect
• Ostium primum atrial septal defect
• Sinus venosus atrial septal defect

Why is an atrial septal defect a concern ?

This heart defect can cause lung problems if not repaired. When blood passes through the ASD from the left atrium to the right atrium, a larger volume of blood than normal must be handled by the right side of the heart. Extra blood then passes through the pulmonary artery into the lungs, causing higher pressure than normal in the blood vessels in the lungs.

The lungs are able to cope with this extra pressure for a while, depending on how high the pressure is. After a while, however, the blood vessels in the lungs become diseased by the extra pressure...

What are the symptoms of an atrial septal defect ?

Many children have no symptoms and seem healthy. However, if the ASD is large, permitting a large amount of blood to pass through to the right side of the heart, the right atrium, right ventricle, and lungs will become overworked, and symptoms may be noted.

The symptoms of an atrial septal defect may resemble other medical conditions or heart problems. Always consult your child's physician for a diagnosis...

How is an atrial septal defect diagnosed ?

A pediatric cardiologist specializes in the diagnosis and medical management of congenital heart defects, as well as heart problems that may develop later in childhood. The cardiologist will perform a physical examination, listening to the heart and lungs, and make other observations that help in the diagnosis. The location within the chest that the murmur is heard best, as well as the loudness and quality of the murmur (harsh, blowing, etc.) will give the cardiologist an initial idea of which heart problem your child may have...

Treatment for atrial septal defect

Usually, an ASD will be repaired if it has not closed on its own by the time your child starts school - to prevent lung problems that will develop from long-time exposure to extra blood flow. The decision to close the ASD may also depend on the size of the defect. Individuals who have their atrial septal defects repaired in childhood can prevent problems later in life. Secundum atrial septal defects may close spontaneously as a child grows. Once an atrial septal defect is diagnosed, your child's cardiologist will evaluate your child periodically to see whether it is closing on its own...

Post-procedure care for your child

Sevice closure procedure

When the procedure is complete, the catheter(s) will be withdrawn. Several gauze pads and a large piece of medical tape will be placed on the site where the catheter was inserted to prevent bleeding. In some cases, a small, flat weight or sandbag may be used to help keep pressure on the catheterization site and decrease the chance of bleeding. If blood vessels in the leg were used, your child will be told to keep the leg straight for a few hours after the procedure to minimize the chance of bleeding at the catheterization site...

Surgical repair

In most cases, children will spend time in the intensive care unit (ICU) for several hours, or overnight, after an ASD repair. During the first several hours after surgery, your child will most likely be drowsy from the anesthesia that was used during the operation, and from medications given to relax him/her and to help with pain. As time goes by, your child will become more alert...

Your child may need other equipment, not mentioned here, to provide support while in the ICU, or afterwards. The hospital staff will explain all of the necessary equipment to you...

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