Atrial septal defect indications for surgical repair in adults
Indications for atrial septal defect in adults-
1)Development of symptoms ( such as shortness of breath, exercise intolerance, fatigue, swelling of feet and ankle or abdomen (suggesting right sided heart failure), recurrent respiratory infections, heart palpitations or skipped beats, (racing heart, awareness of heart beats). Arrrhythmias as an isolated symptom can occur in 1 out of 5 adults patients with atrial septal defects. The surgical closure for patients presenting only with arrhythmia is controversial as not much benefit could be derived even after surgery. Similarly, closure of defect (patent foramen ovale and atrial septal defect) in patients with migraine is controversial (patent foramen ovale and atrial septal defect) 2) High shunting of blood across the defect 3)** A large left-to-right shunt that is either symptomatic or having significant right heart enlargement 4)There are no systematic data that identify a threshold value for Qp/Qs for repair of an ASD. A Qp/Qs >2:1 is a well-established indication '5)'The American Heart Association has recommended a threshold Qp/Qs ≥1.5:1 [1] '6)'The Canadian Cardiac Society recommended a threshold Qp/Qs >2:1, or >1.5:1 in the presence of reversible pulmonary hypertension[2]. For this reason, serial measurements of Qp/Qs by echocardiography are typically performed every two to three years.
- ↑ Driscoll D, Allen HD, Atkins DL, Brenner J, Dunnigan A, Franklin W; et al. (1994). "Guidelines for evaluation and management of common congenital cardiac problems in infants, children, and adolescents. A statement for healthcare professionals from the Committee on Congenital Cardiac Defects of the Council on Cardiovascular Disease in the Young, American Heart Association". Circulation. 90 (4): 2180–8. PMID 7923709.
- ↑ Therrien J, Dore A, Gersony W, Iserin L, Liberthson R, Meijboom F; et al. (2001). "CCS Consensus Conference 2001 update: recommendations for the management of adults with congenital heart disease. Part I.". Can J Cardiol. 17 (9): 940–59. PMID 11586386.