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Atrial Septal Defect

Updated: Jun 2, 2022




What is a Atrial Spetal Defect ( ASD)?

An opening or hole (defect) in the wall (septum) that separates the upper two chambers of the heart i.e the right and left atria. As a result of which the oxygenated blood coming from the lungs into the left upper chamber (left Atria) atria passes through this defect in to the right upper chamber (right Atria) and mixes with the impure blood coming from the whole body and entering the right upper chamber.


What are the causes of ASD in child?

There are no known causes of ASD, but there are some genetic factors and its also seen syndromic children.


What is the effect of ASD on child’s heart?

Due to mixing of blood from left to right, the right sided lower chamber tend to enlarge, there is dilatation and increase the pressure of the arteries, which connect the right heart with lungs. The pressure in the arteries tend to increase gradually and when it reaches above the systemic pressure blood tends to mix from right to left and when this stage is reached ASD cannot be treated.


What are the Symptoms of ASD in children?

Most of the ASD are asymptomatic in childhood and are usually diagnosed when any child with heart murmur (sound heard in the cardiac area with a stethoscope)undergoes an echocardiographic evaluation form a PediatricCardiologist. Sometimes children with large ASD can have recurrent chest infections (i.e. 2 or more in six months or more than three in a year which require antibiotics), reduced weight gain also known as Failure to thrive and difficulty in breathing on running or playing. Smaller ASD tend to remain asymptomatic.


Can ASD close on its own?

Smaller ASD can close spontaneously but chances of larger ASD i.e greater than 8mm may reduce in size but are unlikely to close on its own . Other types of ASD such as Sinus Venosus ASD, Ostium Primum ASD never close on their own.


What is the treatment of ASD?

There are several types of ASD,but the most common type of ASD is Ostium Secundum ASD can be closed non surgically by catheter based intervention techniques using a device after assessment by a Pediatric Cardiologist. In some ASD which do not have a adequate rims need to be closed surgically.Other types of ASD such as Sinus Venosus ASD, Ostium Primum ASD, coronary sinus type of ASD needs to be closed surgically.


ASD
What is the usual age at which ASD should be closed?

Ideally ASD should be closed before child joins any school, usually between 2- 5 years of age and in case of very large ASD where child is symptomatic can be closed below 1 year of age also. Sinus Venosus type of ASD are closed at slightly older i.e around 4-5 year of age.


What is the Prognosis after Treatment?

Once the ASD has been closed either with device or surgically is cured and child can have a normal life.

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