Atrial septal defect(ASD) repair cost in India

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What is ASD?

An atrial septal defect (ASD) is a hole in the wall (septum) between the two upper chambers of your heart (atria). The condition is present at birth (congenital). Small defects might be found by chance and never cause a problem. Some small atrial septal defects close during infancy or early childhood. The hole increases the amount of blood that flows through the lungs. A large, long-standing atrial septal defect can damage your heart and lungs. Surgery or device closure might be necessary to repair atrial septal defects to prevent complications.

Symptoms

Many babies born with atrial septal defects have no signs or symptoms. Signs or symptoms can begin in adulthood which includes:

• Shortness of breath, especially when exercising
• Fatigue
• Swelling of legs, feet or abdomen
• Heart palpitations or skipped beats
• Stroke
• Heart murmur, a whooshing sound that can be heard through a stethoscope

Doctors know that heart defects present at birth (congenital) arise from errors early in the heart's development, but there's often no clear cause. Genetics and environmental factors might play a role.

Types of atrial septal defect

There are several types of atrial septal defects, including:

• Secundum. This is the most common type of ASD and occurs in the middle of the wall between the atria (atrial septum).
• Primum. This defect occurs in the lower part of the atrial septum and might occur with other congenital heart problems.
• Sinus venosus. This rare defect usually occurs in the upper part of the atrial septum and is often associated with other congenital heart problems.
• Coronary sinus. In this rare defect, part of the wall between the coronary sinus — which is part of the vein system of the heart — and the left atrium is missing.

Risk Factors

It's not known why atrial septal defects occur, but some congenital heart defects appear to run in families and sometimes occur with other genetic problems, such as Down syndrome. If you have a heart defect, or you have a child with a heart defect, a genetic counselor can estimate the odds that future children will have one. Some conditions that you have during pregnancy can increase your risk of having a baby with a heart defect, including:

• Rubella infection. Becoming infected with rubella (German measles) during the first few months of your pregnancy can increase the risk of fetal heart defects.
• Drug, tobacco or alcohol use, or exposure to certain substances. Use of certain medications, tobacco, alcohol or drugs, such as cocaine, during pregnancy can harm the developing fetus.
• Diabetes or lupus. Having diabetes or lupus might increase your risk of having a baby with a heart defect

Prevention

In most cases, atrial septal defects can't be prevented. If you're planning to become pregnant, schedule a visit with your health care provider. This visit should include:

• Getting tested for immunity to rubella. If you're not immune, ask your doctor about getting vaccinated.
• Going over your current health conditions and medications. You'll need to monitor certain health problems during pregnancy. Your doctor might also recommend adjusting or stopping certain medications before you become pregnant.
• Reviewing your family medical history. If you have a family history of heart defects or other genetic disorders, consider talking with a genetic counselor to determine what the risk might be.

Diagnosis

For a suspected heart defect, your doctor might request one or more of the following tests:

• Echocardiogram. This is the most commonly used test to diagnose an atrial septal defect. Sound waves are used to produce a video image of the heart. It allows your doctor to see your heart's chambers and measure their pumping strength. Doctors can also use this test to evaluate your condition and determine your treatment plan.
• Chest X-ray. This helps your doctor see the condition of your heart and lungs. An X-ray can identify conditions other than a heart defect that might explain your signs or symptoms.
• Electrocardiogram (ECG). This test records the electrical activity of your heart and helps identify heart rhythm problems.
• Cardiac catheterization. A thin, flexible tube (catheter) is inserted into a blood vessel at your groin or arm and guided to your heart. Through catheterization, doctors can diagnose congenital heart defects, test how well your heart is pumping, check heart valve function and measure the blood pressure in your lungs. However, this test usually isn't needed to diagnose an atrial septal defect. Doctors might also use catheterization techniques to repair heart defects.
• MRI. This uses a magnetic field and radio waves to create 3D images of your heart and other organs and bodily tissues. Your doctor might request an MRI if echocardiography can't definitively diagnose an atrial septal defect or related conditions.
• CT scan. This uses a series of X-rays to create detailed images of your heart. It can be used to diagnose an atrial septal defect and related congenital heart defects if echocardiography hasn't definitely diagnosed an atrial septal defect.

Treatment

Many atrial septal defects close on their own during childhood. For those that don't close, some small atrial septal defects might not require treatment. But many persistent atrial septal defects eventually require surgery.

Medical monitoring

If you or your child has an atrial septal defect, your cardiologist might recommend monitoring it for a time to see if it closes on its own. Your doctor will decide when you or your child needs treatment, depending on your condition and whether you or your child has other congenital heart defects.

Medications

Medications won't repair the hole, but they may be used to reduce some of the signs and symptoms that can accompany an atrial septal defect. Drugs may also be used to reduce the risk of complications after surgery.

Surgery

Many doctors recommend repairing a medium to large atrial septal defect diagnosed during childhood or adulthood to prevent future complications. However, surgery isn't recommended if you have severe pulmonary hypertension because it might make the condition worse. For adults and children, surgery involves sewing closed or patching the abnormal opening between the atria. Doctors will evaluate your condition and determine which of two procedures to use:

• Cardiac catheterization. Doctors insert a thin, flexible tube (catheter) into a blood vessel in the groin and guide it to the heart using imaging techniques. Through the catheter, doctors place a mesh patch or plug to close the hole. The heart tissue grows around the mesh, permanently sealing the hole. This type of procedure is used to repair only the secundum type of atrial septal defects. Some large secundum atrial septal defects, however, might require open-heart surgery.

• Open-heart surgery. This type of surgery is done under general anesthesia and requires the use of a heart-lung machine. Through an incision in the chest, surgeons use patches to close the hole. This procedure is the only way to repair primum, sinus venosus and coronary sinus atrial defects. This procedure can be done using small incisions (minimally invasive surgery) and with a robot for some types of atrial septal defects.