10 Recent advances in managing septal defects

In children and adults, atrial septal abnormalities are the third most frequent kind of congenital heart abnormality. A hole in the septum, the muscle wall separating the heart’s two upper chambers, is known as an atrial septal defect (ASD). An ASD is a birth disorder that results from improper septum formation. The heart and lungs have to work harder to pump the additional blood into the lung arteries when the ASD is big, and the lung arteries may eventually deteriorate. Atrial septal defect surgery is the most common treatment that is carried out in nations like Kenya to treat this foetal issue.

Contents

1 Diagnosis for Atrial Septal defect
- 1.1 Summary:

Diagnosis for Atrial Septal defect

Some atrial septal abnormalities are identified either before or shortly after birth. The following tests are performed to assist in identifying an atrial septal defect.

Echocardiogram:

This is the most frequently used test to identify atrial septal defects. How well the heartbeat and heart valve function may be seen during echocardiography. Pictures of the beating heart are made using sound waves.

Electrocardiogram:

This rapid and simple examination captures the heart’s electrical activity. An ECG can detect erratic heartbeats and is widely used for atrial septal defect repair.

Cardiac magnetic resonance imaging scan:

This procedure produces fine-grained pictures of the heart using radio waves and magnetic fields. Only a top cardiac surgeon in India is recommended for this . If echocardiography fails to provide a clear diagnosis, doctors of Ghana may order this kind of MRI before atrial septal defect surgery.

Right heart catheterisation: –

A tiny, thin tube called a catheter is introduced into the heart through a peripheral vein. In each heart chamber, pressures and blood oxygen saturation levels are monitored. How much blood flows over the ASD depends on the oxygen levels. To determine the extent of the defect, the doctor may also use a small balloon at the tip of the tube or a specific dye.

Left heart catheterisation:

A catheter injects a particular dye into the heart’s blood arteries during this treatment (angiography). The examination can detect coronary heart disease.

ASD repair procedure:

The kind and extent of the defect, heart impacts, and any other medical disorders you may have, such as pulmonary arterial hypertension, valve disease, or coronary artery disease, will all affect how you are treated if you have an ASD and can lead to atrial septal defect surgery.

No surgical treatment:

For most patients with ASDs, nonsurgical correction is the chosen course of action. The septal hole is sealed with a device in this form of repair. For percutaneous ASD closure, two distinct brands of closure devices are authorised. You will undergo a catheterisation to assess the location and size of the defect and monitor pressure in your heart if your doctor advises this form of repair.

AMPLATZER® Septal Occluder:

A transcatheter closure tool used for treating ASDs is the AMPLATZER® Septal Occluder. It is made up of two discs of polyester fabric-filled Nitinol wire mesh. A vein in the leg is used to introduce the catheter, which is pushed through the atrial septum defect. The device is carefully pulled to the external of the catheter once in the correct position so that its discs rest, like a sandwich, on either side of the defect.

GORE HELEX® Septal Occluder:

A single Nitinol wire frame supports the disc-shaped GORE HELEX® Septal Occluder, which is made of ePTFE patch material. The gadget fills the septal hole. Using a catheter, the device is inserted and then gradually pushed out, till it completely covers the imperfection.

Surgical repair:

To treat big ASDs and other ASD types, atrial septal defect surgery may be required. In some circumstances, this can be accomplished using a robot or a minor incision. Atrial septal defect repair surgery entails patching up the heart defect for adults and children. Two methods exist for doing this:

Catheter-based repair:

Utilising imaging methods, a small, flexible tube is placed into a blood artery, typically in the groyne, and directed to the heart. A mesh patch or plug is inserted via the catheter to plug the hole. The hole is permanently sealed when heart tissue develops around the seal. Only atrial septal abnormalities of the second type are repaired using catheters. However, certain big Secundum atrial septal abnormalities may need open heart surgery.

Open-heart surgery:

An incision in the chest wall is made to immediately reach the heart during this kind of ventricular septal defect repair surgery. To seal the hole, the surgeons employ patches. Primum, sinus venosus and cardiac sinus atrial abnormalities may only be corrected with this open-heart surgery. Atrial septal defect correction can occasionally be done utilising a robot and minimally invasive surgery (robot-assisted heart surgery).

Medications:

Atrial septal defects cannot be repaired, although medications can assist with signs and symptoms. Beta-blockers, which regulate heartbeat or lower the danger of blood clots, may be used for atrial septal defect repair.

Home Remedies:

The medical professional may suggest certain lifestyle changes if you or your kid has a ventricular septal defect to maintain heart health and avoid consequences. When an atrial septal defect is present, exercise is often safe. However, if ASD repair is required, a doctor could advise against doing specific things until the heart defect is corrected.

Summary:

Anyone who has undergone an atrial septal defect surgery should undergo routine echocardiograms and physical examinations to monitor for potential side effects, such as arrhythmias, heart valve issues, pulmonary hypertension, heart failure, and high blood pressure in the arteries of the lungs. Large atrial septal defects often result in poorer long-term prognoses in patients who do not receive surgery to seal the hole.