Cardiosurgery: Atrial septal defect (ASD) after myocardial infarction (heart attack) — Reconstruction and coronary artery bypass surgery. Treatment
Atrial septal defect (ASD) is one of the most common congenital heart diseases. It accounts for about 12 to 14% of all congenital heart defects. ASD is developed in utero under the influence of genetic, infectious, toxic, radiological and endocrine factors. In many cases, a small septal defect is asymptomatic or has a nonspecific blurred clinical picture in the childhood, but in adulthood, ASD can be manifested by heart and lung failure, arrhythmia, or vertigo.
Atrial Septal Defect Treatment Options
Usually, ASD does not lead to acute life-threatening conditions, so the need for urgent surgery is extremely rare. Upon compensated defect, when the symptoms of circulatory failure are mild, the patient is prescribed a conservative treatment, which, though does not eliminate the cause of the disease, but helps normalize the heart and blood vessel operation.
The only option to fully restore the normal structure of the heart is a surgical treatment, which has a few options. Any technique involves the use of general anesthesia.
- Open surgery with defect suturing is performed upon small diameter of a hole. Access to the heart is ensured through sternotomy, followed by incision of the right ventricle. During surgery, the patient’s heart is switched off, and its function is taken over by the cardiopulmonary bypass.
- Open surgery with defect plastics is indicated for a hole of a considerable diameter. Access to the partition is similar to the previous option, but the hole is sutured and closed with a patch made of synthetic or biological material.
- Endovascular occlusion is a minimally invasive option of defect plastic surgery. The access is ensured via a peripheral vein, into which the special probe with occlude is inserted. The manipulation is monitored by X-ray imaging techniques. The occluder consisting of two plates is installed on the partition in the defect area, and then the system is inflated and fixed firmly. Subsequently, the occluder material is covered by the growing tissues and allows for normal blood flow in the heart cavities.
The surgery carried out by a highly skilled heart surgeon in a modern equipped clinic allows hoping for a positive long-term outcome in 94% cases.Hide