asd_flashcards
What is an Atrial Septal Defect (ASD)?
A defect in the septum between the two atria, with three main types: Ostium secondum, Patent foramen ovale (not a true ASD), and Ostium primum.
What is the most common type of ASD?
Ostium secondum, where the septum secondum fails to fully close.
What type of ASD is not considered a true ASD?
Patent foramen ovale, where the foramen ovale fails to close.
What is a distinguishing feature of Ostium primum ASD?
It commonly leads to an atrioventricular valve defect.
What is the classic murmur associated with ASD?
A mid-systolic, crescendo-decrescendo murmur loudest at the upper left sternal border with fixed splitting of the second heart sound.
Who should manage children with an ASD?
A paediatric cardiologist.
What is the main management strategy for small or asymptomatic ASDs?
Observation.
When is closure of an ASD generally deferred until in asymptomatic patients?
After two years of age.
What are the two approaches for ASD closure?
Transcatheter closure and open heart surgery.
Which type of ASD is typically treated with transcatheter closure?
Ostium secundum ASD.
What are the benefits of transcatheter closure compared to surgery?
Similar likelihood of success, with lower complication rates and shorter duration of hospital stay.
Which type of ASD is typically treated with open heart surgery?
Primum ASD (and sometimes Secundum ASD).
What are the indications for closure of an ASD?
Right heart enlargement, symptomatic pulmonary over circulation, and substantial left-to-right shunting with a ratio of pulmonary to systemic blood flow greater than 1.5.
What findings are typically associated with the need for ASD closure?
Moderate to large ASDs which are unlikely to spontaneously close.
