General Information About ASD
Disease Details and Frequently Asked Questions
It is the mixing of blood between the right and left chambers due to a congenital (left open) hole in the upper wall (septum) separating the clean and dirty blood of the heart.
It is caused by the wall failing to close completely (due to genetic or environmental factors) during the baby's development in the womb.
Difference: ASD is a hole between the upper chambers (Atria), and because the pressure is low, it is noticed late. VSD is a hole between the heart's main engines (lower chambers/Ventricles), the pressure is very high, and it manifests itself with severe heart failure as soon as the baby is born.
ASD is usually VERY INSIDIOUS in childhood and shows no symptoms. Children develop normally, run, and play. It is often diagnosed incidentally when a doctor hears an extra 'MURMUR' (sound of splashing water) while listening to the heart with a stethoscope during a routine examination.
If the hole is large and not closed, extra blood is pumped to the right heart every second. Over the years (in their 30s-40s), the heart cannot bear this load and enlarges massively to the right (Right Heart Failure). Blood pressure in the pulmonary vessels rises fatally (Pulmonary Hypertension). Additionally, a small clot breaking off from the leg can easily pass through this hole, go directly to the BRAIN, and cause a STROKE (Paradoxical Embolism).
The Gold Standard method is Echocardiography (Heart Ultrasound). The location and diameter of the hole are measured in the ultrasound taken from the chest. Sometimes, to see the hole more clearly (and to decide on surgery), a TEE (Transesophageal ECHO) is performed by passing a small tube through the patient's mouth down into the esophagus.
The decision depends on the size of the hole (Very small ones close on their own or are left untouched). If the hole needs closing, one of the Most Amazing Methods in Medicine is applied:
Non-Surgical Closure (Percutaneous Umbrella): The chest is not opened! The heart is reached via a small wire inserted through the patient's GROIN (from the vein). A foldable Double-Headed Umbrella (Plug) made of special nitinol wire is left right in the middle of the hole. The umbrella opens, squeezes the hole from both sides like a sandwich, and closes it. The procedure takes 30 minutes, and the patient returns to normal life the next day.
Open Surgery: If the hole is very large or its location is not suitable for an umbrella, open-heart surgery is performed to sew a patch over that hole, curing the disease definitively.
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