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Atrial septal defect (ASD) is a congenital heart defect in which blood flows between the atria (upper chambers) of the heart.Some flow is a normal condition both pre-birth and immediately post-birth via the foramen ovale; however, when this does not naturally close after birth it is referred to as a patent (open) foramen ovale (PFO).
A typical use of ICE is for performing a transseptal puncture across the interatrial septum; in other words, pushing a catheter from the right atrium to the left atrium. Next to the septum is the aorta, and puncturing from the right atrium to the aorta is dangerous, and ICE visualization increases the confidence of performing this procedure safely.
The operation is performed under general anesthesia. The four pulmonary veins are reconnected to the left atrium, and any associated heart defects such as atrial septal defect, ventricular septal defect, patent foramen ovale, and/or patent ductus arteriosus are surgically closed. With obstruction, surgery should be undertaken urgently.
Although closure of a patent foramen ovale or atrial septal defect theoretically removes the pathway for an arterial embolus to enter venous circulation and cause a paradoxical embolism, data suggests that closing intracardiac shunts is no more effective than medical management alone in preventing strokes. [2]
An Atrial septal defect is a relatively common heart malformation that occurs when the interatrial septum fails to develop properly. Persistence of the ostium secundum is the most common atrial septal defect. [3] Additionally, in a subset of the population, the foramen ovale is not overtly patent but the two septa have not fused.
The atrial septum separates the right and left atrium of the heart, and an atrial septal defect describes when there’s some opening in a baby’s heart between these two upper chambers. But how does this opening form? Well, let’s first run how the septum develops in the first place.
Eisenmenger syndrome or Eisenmenger's syndrome is defined as the process in which a long-standing left-to-right cardiac shunt caused by a congenital heart defect (typically by a ventricular septal defect, atrial septal defect, or less commonly, patent ductus arteriosus) causes pulmonary hypertension [1] [2] and eventual reversal of the shunt into a cyanotic right-to-left shunt.
The ostium primum atrial septal defect is a defect in the atrial septum at the level of the tricuspid and mitral valves. This is sometimes known as an endocardial cushion defect because it often involves the endocardial cushion, which is the portion of the heart where the atrial septum meets the ventricular septum and the mitral valve meets the tricuspid valve.