Atrial septal defect

Atrial septal defect (ASD) is a non-cyanotic congenital heart defect, which is divided into secundum and primum.

Secundum septal defect
Very common defect due to persistence of the foramen ovale, atrioventricular valves are normal. It occurs 3 times more often in girls. Usually diagnosed as an accidental finding.

The clinical picture
Usually without difficulties in childhood. In adulthood, reduced performance, arrhythmias (especially atrial flutter ), atrial enlargement, right ventricular enlargement (even heart failure) may occur (in the event of a major short circuit ). With increased venous pressure (eg childbirth), paradoxical embolization can occur (through a defect into the large circulation). Auditory finding: rather than a murmur, the pediatrician is attracted by a fixed cleft II. sounds above the lungs.

Prognosis and treatment
The prognosis is usually favorable, complications do not appear until the 3rd decade or later.

For all patients (including asymptomatic patients) closure of the defect (catheterization or open surgery) is recommended, the procedure should be performed on children younger than school age.

Atrial septal defect primum type
A more serious defect that is accompanied by a cleft of the anterior mitral valve. This results in mitral regurgitation and left-right shorting. Often present in Down syndrome.

The clinical picture
A small defect is usually asymptomatic, mitral regurgitation progresses during life, a larger defect is accompanied by frequent lung infections and leads to heart failure.

Treatment
Surgical closure of the defect with a patch.

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