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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.
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