Atrial Septal Defects (ASD)

Interatrial communications are common congenital cardiac defects that range from clinically insignificant to hemodynamically important lesions with symptoms of right heart overload which are life-shortening if not closed. There are four main anatomical types (in order of frequency): secundumSecundum ASDAtrial septal defect (ASD), sinus venosusSinus venosus defect, primum defectPrimum Defect and undroofed coronary sinus. ASDsAtrial septal defect (ASD) commonly occur in association with other cardiac defects. Surgery is indicated if the resulting Qp/Qs is > 1.5 or there is progressive RVBorderline right ventricle (RV) volume loading. If the anatomy is suitable, device closure by interventional catheter is preferred – but is mainly limited to secundumSecundum defects. Most other significant defects require surgical repair involving different patching techniques that ensure adequate separation of left and right atrium and rerouting of venous return, as well as correcting any associated lesions. Defects in older patients need careful evaluation to assess a patient’s operability. Surgical risk is very low and returns life expectancy to that of the normal population.