Atrial Septal Defect (ASD) is a type of congenital heart defect (CHD) that occurs at birth. Normally, the oxygenated blood from the lungs comes into the left atrium, passes into the left ventricle, and then to the main blood tube called Aorta. But in this condition, there is a hole (defect) in the partition (atrial septum) which is present between the upper two chambers of the heart (the right and the left atrium). A portion of the blood from the left atrium goes into the right atrium, on to the right ventricle, and then to the lung. This circulatory pattern causes a chronic overload of the right-sided cardiac chambers, and there is always an increased blood flow into the lungs. A dividing wall separates the atria, and if this wall is defective or absent, it can cause complications for the baby.
ASD may be the only defect (Isolated), or it may be part of other defects in the child with a complex heart defect. Isolated ASD accounts for 10 -15 % of all forms of CHD. The incidence of CHD is 7 per thousand live births.
Depending on the location of the defect in the atrial septum, ASD is classified into the following major types:
Sinus Venosus Atrial Septal Defect (defects near the great veins)
Secundum Atrial Septal Defect (in the midportion of the septum)
Primum Atrial Septal Defect (defect near the main valves of the heart)
The causes for the development of ASD (like for all CHD) are not known. Maternal diabetes, certain viral infections, and the use of certain drugs in early pregnancy increase the chance of CHD.
Symptoms that do occur may begin at any time after birth through childhood, and can include:
Difficulty breathing (dyspnea)
Frequent respiratory infections in children
A sensation of feeling the heartbeat in adults
Shortness of breath
In the vast majority, babies born with ASD will have no symptoms. However, 5-10 % of babies with moderate to large defects may need surgery at infancy due to the occurrence of heart failure. If not treated, by the age of 30-40 years, signs of palpitation develop. In some patients, by this time, irreversible changes occur in the pulmonary arteries, which make the ASD inoperable. Such a condition is called Eisenmenger syndrome.
The Paediatric Cardiology Department at Max Hospitals is one of the finest child care centres in India ‘Where Children Come First’. Our state-of-the-art Neonatal Intensive Care Units (NICU) and Paediatric Intensive Care Unit (PICU) provides complete care and support to critically ill children. Our General Paediatrics experts specialize in treating a range of newborn problems, issues, and conditions, including Atrial Septal Defect.
We are a one-stop destination for childcare services that include paediatric surgical, paediatric, and immunization services for children aged up to 16 years. We have a team of experienced paediatricians and paediatric surgeons who specialize in paediatric surgery, paediatric orthopaedics, paediatric endocrinology, paediatric cardiology & cardiac surgery, paediatric pulmonology, paediatric nephrology, paediatric oncology, paediatric haematology, developmental specialists, and adolescent paediatrics.
To take care of your children, our pediatricians will:
Perform physical exams
Make sure the child meets milestones in growth, behaviour, and skills
Diagnose and treat the child's infections, illnesses, health problems, and other injuries
Provide information about the child's health, nutrition, safety as well as fitness needs
Answer questions about the child’s development and growth
Refer the child to specialists if they think the child requires expert care
While the baby is in the womb, there is normally an opening between the upper chambers of the heart (atria) to allow blood to flow around the lungs. This opening usually closes around the time when the baby is born. If the opening does not close, the hole is called an atrial septal defect, or ASD.
The Paediatric Cardiology Department at Max Healthcare provides all non-invasive diagnostic and paediatric cardiac interventional services. Surgery and device closure are done routinely at extremely low risks (less than 1%). Sinus Venosus and Primum defects are generally closed by surgery, while most Secundum defects can be closed without surgery.
Our treatment options for Atrial Septal Defect include:
Cardiac catheterization: A thin tube (catheter) is inserted into a blood vessel in the groin and guided to the heart. Through the catheter, a mesh patch or plug is put into place to close the hole. The heart tissue grows around the mesh, permanently sealing the hole
Open-heart surgery: This type of surgery is done under general anaesthesia and requires the use of a heart-lung machine. Through an incision in the chest, surgeons use patches or stitches to close the hole. Such minimally invasive heart surgery where the incision is very small (4 - 5 cm long) is also called Keyhole surgery.
Treatment using ASD device: Most Secundum ASDs can be closed using the ASD device (most commonly used device). This procedure is done through a needle puncture in the vein in the groin. The patient is discharged the next day.