Pediatric Cardiac Surgery - Atrial Septal Defects

Atrial septal defects (ASD) are congenital heart defects in the wall separating the upper heart chambers, known as the Atria. During fetal development, this space remains open between the two atria so blood can bypass the developing lungs, as a fetus gets its oxygen saturation from the mother.

This wall is supposed to close at birth, however, an atrial septal defect is present when this wall does not completely close. Depending on the size of the defect, pediatric heart surgery may be needed.

The Risks of ASD and the Need for Pediatric Cardiac Surgeryr
If the defect is persistent and the atrial wall does not close, the blood will continue to flow from the left to the right atria in the heart. In larger defects, too much blood can flow through the atria, which can cause pressure to build in the lungs. In advanced cases of large defects and increased pressure, the result is a reversal in blood flow, which can lead to breathing complications.

While atrial septal defects are not common, some do present symptoms, and due to complications, need to be corrected with pediatric cardiac surgery. For some, symptoms may be completely absent and may not become present until the child grows. Those with an uncorrected atrial septal defect are at risk for developing a number of complications that include:

Atrial Fibrillation (as adults) - An irregular and often rapid heartbeat that results in poor circulation. This is due to the upper chambers (the atria) beating chaotically and irregularly out of coordination with the lower chambers of the heart.

Heart Failure - Because of the defect, the heart is unable to properly pump enough blood through the body in order to meet the needs of the organs and tissue. This forces the heart to work harder and over time, the heart gradually weakens or becomes too stiff to fill and pump effectively.

Pulmonary Hypertension - This heart defect can result in pulmonary hypertension, which is abnormally high blood pressure in the arteries of the lungs. Pulmonary hypertension forces the right side of the heart to work harder than normal.

Pediatric Cardiac Surgery - Symptoms Associated with ASD
Small to moderate heart defects may produce no symptoms or problems until a child grows well into their adult years. In those cases, they often go undetected, so pediatric cardiac surgery isn't necessary. Larger defects can produce symptoms early on, or these symptoms can appear later in adults with moderate defects:

* Difficulty breathing
* Respiratory infections (more common in children)
* Heart palpitations
* Shortness of breath with activity.

Pediatric Cardiac Surgery - Treatment of ASD
Atrial septal defects may require no treatment at all if a patient shows few or no symptoms. In most cases, this is because the defect is so small it is not likely to negatively impact circulation and oxygenation of the blood. In cases of a larger defect, more prominent symptoms could affect quality of life that may potentially lead to a fatal outcome. In cases such as this, pediatric heart surgery is often used to correct the defect.