Surgery to close the atrial septal defect

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1. Symptoms of atrial septal defect

Many babies born with atrial septal defects have no clinical signs or symptoms. Signs or symptoms may begin to appear in adulthood.
Signs and symptoms of atrial septal defect may include:
Shortness of breath, especially during exercise or strenuous activity Fatigue Swollen feet, feet Heart pounding or skipping stroke Heart murmur, a hissing sound that can be heard through a stethoscope A large atrial septal defect can increase blood flow to the lungs and make the heart work harder. If left untreated, the right side of the heart will eventually enlarge and weaken. Pulmonary arterial pressure may also increase, also known as pulmonary hypertension.

2. Atrial septal defect and pregnancy

Most women with an atrial septal defect can go through pregnancy without problems related to the defect. However, having a larger defect or having complications such as heart failure, arrhythmia, or pulmonary hypertension can increase the risk of complications during pregnancy.
Doctors strongly advise women with Eisenmenger syndrome, a serious complication of an atrial septal defect, not to become pregnant because it can be life-threatening. The risk of congenital heart disease is higher for the children of parents with congenital heart disease. Anyone with a congenital heart defect, repaired or not, who is considering starting a family and having children should talk to their doctor. Your doctor may recommend surgical repair before you become pregnant.

3. Causes of atrial septal defect

The heart is divided into four chambers, two on the right and two on the left. To pump blood around the body, the heart uses its left and right sides with different tasks. The right side of the heart pumps blood to the lungs. In the lungs, the blood picks up oxygen then returns it to the left heart. The left part of the heart pumps blood through the aorta to the rest of the body.
Why does atrial septal defect occur? Doctors believe that congenital heart defects arise from errors in the early development of the heart, but often there is no clear cause. Genetics and environmental factors may play a role.
Although it is not known why atrial septal defects occur, some congenital heart defects seem to run in families and sometimes co-occur with other genetic abnormalities, such as down syndrome . If you have a heart defect, or you have a child with a heart defect, a genetic counselor can estimate the odds that future children will have it. Certain conditions that you have during pregnancy can increase your risk of having a baby with a heart defect, including:
Rubella infection. Being infected with rubella (German measles) during the first few months of pregnancy can increase the risk of fetal heart defects. Using drugs, tobacco or alcohol, or being exposed to certain chemicals. Using certain drugs, tobacco, alcohol, or drugs, such as cocaine during pregnancy, can harm a developing fetus and increase the risk of an atrial septal defect. Diabetes or lupus. Women with diabetes or lupus may have an increased risk of having a baby with a heart defect.

4. How to close the atrial septal defect?

Many doctors recommend repairing a moderate to large atrial septal defect diagnosed during childhood or adulthood to prevent future complications. However, surgery is not recommended if severe pulmonary hypertension is present because it can make the person's health worse.
For adults and children, surgery includes stitches to close or patch the septal defect. Doctors will assess the patient's condition and determine which of the following two procedures should be used:
Cardiac catheterization : Doctors insert a thin, soft, flexible tube (catheter) into a blood vessel in the groin and guide it to the heart with the help of imaging techniques. Through the catheter, doctors place a patch or mesh plug to close the stoma. Heart tissue grows around the mesh, sealing the hole permanently. This type of procedure is only used to correct this type of atrial septal defect. However, some large atrial septal defects may require open heart surgery. Open heart surgery. This type of surgery is performed under general anesthesia and requires the use of a heart-lung machine. Through an incision in the chest, the surgeon uses patches to close the atrial septal defect. This procedure is the only way to repair atrial septal defects located near the vena cava, venous sinuses, and coronary sinuses. This surgery can be done using smaller incisions, called minimally invasive surgery and robotic surgery for some forms of atrial septal defects. After surgery, patients need to be closely monitored blood pressure, pulse, breathing rate. Drainage is placed in most patients, so it is necessary to monitor the characteristics of the discharge from the tube such as quantity, color, and sediment. Follow-up care depends on the location of the atrial septal defect, the treatment chosen, and other congenital heart defects, if present.
Repeat echocardiography is performed after hospital discharge, one year later, and thereafter at the discretion of the physician to monitor and detect long-term complications if present. For simple atrial septal defects that close on their own in childhood, routine follow-up care is usually sufficient without major intervention. Adults who have had an atrial septal defect repair need to be monitored throughout life to check for complications, such as pulmonary hypertension, arrhythmias, heart failure, or valve problems.
The truth is, medications won't repair an atrial septal defect, but they can be used to relieve some of the signs and symptoms that may accompany an atrial septal defect. Medicines may also be used to reduce the risk of complications after surgery. Cardiac arrhythmia-modifying drugs such as beta-blockers or anticoagulants that reduce the risk of blood clots are commonly used after cardiac surgery.

5. Is atrial septal defect preventable?

In most cases, atrial septal defect cannot be prevented. If you are planning to become pregnant, schedule a visit with your healthcare provider.
Pre-pregnancy check-up includes the following steps:
Testing for immunity to rubella. If you are not already immune, ask your doctor about getting vaccinated. Assess your current health status and medications you are taking. You will need to monitor these health problems throughout your pregnancy. Your doctor may also recommend adjusting or stopping certain medications before you become pregnant. Take the medical history of the wife, husband and their family. If you have a family history of congenital heart defects or other genetic disorders, consider talking with a genetic counselor to determine what the risk might be.

6. Lifestyle for people who have surgery to close atrial septal defect

If you have a congenital heart defect or you have had surgery to correct one, you may be concerned about limitations in activities and other problems.
Exercise: A deviated atrial septum usually doesn't restrict you from being active or exercising. If you already have complications, such as an arrhythmia, heart failure or pulmonary hypertension, you may be advised to avoid doing certain activities or exercises. Your cardiologist can help you learn what is safe. If you have an uncorrected defect, your doctor will likely advise you to avoid scuba diving and high-altitude mountain climbing.
Prevent infection: Some heart defects and their repair create changes in the surface of the heart that make it more susceptible to infection (infective endocarditis). Atrial septal defects are not generally associated with infective endocarditis, although your doctor will likely recommend prophylactic antibiotics for about six months after surgery to close the stoma is finished. If you have heart defects other than an atrial septal defect or if you have had an atrial septal defect repaired within the past six months, you may need antibiotics before certain dental or surgical procedures.
Currently, all Vinmec International Hospitals nationwide can close the atrial septal defect by percutaneous intervention with a methodical and strict procedure, ensuring safety and accuracy. and provide high treatment efficiency.
Vinmec with advanced equipment and a team of experienced and well-trained doctors and nurses, professional and dedicated patient care services will help patients have the most secure experience during surgery. Minimally invasive open heart here.

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