Atrial Septal Defect Diagnosis

What is a atrial septal defect diagnosis?

An atrial septal defect (ASD) is a hole in the wall and muscle between the two chambers (atria) in the heart. Pressure in the left side of the heart is much higher than the right, meaning an ASD may allow blood from the left atrium to pass to the right atrium. What is a atrial septal defect diagnosis? First, let's better understand ASDs.

Some ASDs are very small and do not cause problems or require treatment. Larger ASDs can, in some cases, result in the right side of the heart being overloaded with blood. If left untreated, over a period of many years it can eventually lead to permanent damage to the heart and sometimes to the lungs.

What are the causes of atrial septal defect (ASD)?

The cause of ASD is not always clear but most cases are due to anomalies in heart formation during the early stages of pregnancy, although genetics and environmental factors can also contribute.

It is rare that any heart problems will have been caused directly by something done by the mother or environment during pregnancy.

Signs and symptoms of atrial septal defect

Most children show either mild or no symptoms at all, however there are some signs.

Common signs include:

  • Repeated chest infections can be a sign that the oxygenation process is not working due to increased blood flow to the lungs.
  • Larger defects can cause further stress on the heart, causing the right side to stretch. Babies may become breathless and display issues when feeding or gaining weight. An older child's inability to breathe may directly impact exercise.
  • Heart murmurs caused by extra blood flow to the lungs can be detected on routine check-ups and is often the cause for most referrals.

How is an strial septal defect (ASD) diagnosed?

ASD can be diagnosed by conducting a painless ultrasound scan on the heart called an echocardiogram.

Treatment for atrial septal defect (ASD)

ASD is treated with:

  • Keyhole surgery
  • Open-heart surgery

The aim of both these surgeries is to close the ASD which stops blood passing from left to right atrium. The type of treatment will depend on the size of the ASD and its exact position.

Keyhole surgery for an atrial septal defect (ASD)

Doctors insert a tube into a patient's food pipe through the mouth to do a scan called a transesophageal echocardiogram to see the heart and ASD clearly. Another long tube known as a catheter is inserted into a vein in the leg and guided toward the heart.

The ASD is closed using a special device, which is folded up and pushed through the catheter to the heart. Once it is in the correct position, the device is unfolded so that the ASD hole is closed. The catheter will then be removed.

The device will stay inside the patient's heart and become covered over by their own tissue during the healing process. Aspirin is prescribed after surgery to reduce the risk of blood clots forming.

What are the risks of keyhole surgery for atrial septal defect (ASD)?

Keyhole treatment to repair an ASD is usually very successful and carries a very low risk of fatality. Most children will not experience any major complications.

Risks of keyhole surgery include:

  • A small risk of bleeding around the heart and a small risk that the device could move out of place after the surgery. If this happens a second operation to remove the device and to close the hole at the same time may be performed.
  • Sometimes the device might not completely close the hole. If this happens your child may need another operation to close the hole around the device.There is a very small risk that the device could become infected and an operation would be needed to remove it.
  • It is very rare, but there is also a very small risk of blood clots forming inside the heart during the surgery which could cause a stroke.

Open-heart surgery for an atrial septal defect (ASD)?

Sometimes open-heart surgery is required to close the ASD. Surgeons will make a cut in the patient's breastbone to get access to the heart. Their heart will be stopped and a ‘heart-lung machine' will be used to function as the heart and lungs.

The surgeon will sew the ASD closed, start the heart beating again and the heart-lung machine will be turned off. The patient's chest will then be sewn closed.

What are the risks of open-heart surgery for atrial septal defect (ASD)?

Open-heart surgery to repair ASD is usually very successful and the fatality risks are very low.

Risks and complications of open-heart surgery for atrial septal defect include:

  • Brain damage
  • Kidney damage
  • Serious lung diseases such as pneumonia

What happens next?

Most children will remain completely well and lead a normal, active life after treatment. There is no need to restrict physical activity and no special precautions are necessary.

Doctors will advise on whether further check-ups are necessary on a case by case basis.