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What is Atrial Septal Defect ?
Figure: Anatomical location of Am
Indication for Surgery : The presence of an ASD or PAPVC (Partial Anomalous Pulmonary Venous Connection) with light ventricular volume overload and a significant left light shunt (Qp/Qs Of < 1.5: 1) is an indication for closure. The optimal age for operation is usually 1 to 2 years. Surgery can be done at very young and very old age. Pulmonary vascular disease which raises pulmonary vascular resistance to >8 units / m2 at rest makes an ASD inoperable. Associated mitral and tricuspid regurgitations are not contra indications for surgery and they might need valve repair.
Generally a very small defect that is less than 5 mm in diameter does not require surgery. However, there is a possibility of paradoxical embolism even in such small defects. If the patient has a history of stroke, closure is advised. Surgical closure is indicated in such cases if device closure is contra indicated or it has failed.
Factors Affecting Fertilizer Requirements The rapid increase in the use of fertilizers is based on the fact that large profits are obtained from the money invested in them. The
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