What is ASD? It concerns the hole between the left and right atrium of the heart, which must close with a valve after birth. In some cases this valve is not large enough to close the hole. In that case we speak of Atrium (=bosom) Septum (=separation) Defect (=missing part). Fortunately, in almost all cases there is no reason to panic.
Clinical picture Atrial Septum Defect
Before birth, there is always an opening between the left and right atrium of the heart. This is necessary because the baby is not yet breathing on its own at that time, and in this way oxygen-rich blood can flow to all parts of the body. This is done via the umbilical cord from the placenta.
Normally, after delivery, the valve closes the opening completely. However, sometimes it happens that the flap is not large enough to completely close the opening. The opening allows blood to flow from one atrium to the other. After birth, the pressure is highest in the left atrium, which is why the blood flows to the right atrium. From here it flows to the lungs where oxygen is absorbed, then the oxygen-rich blood flows to the left atrium. Some of this blood will again follow the route via the right atrium to the lungs, while it is already oxygen-rich blood. Oxygen that has been collected, but not used by the body.
An unnecessary overload of the heart, especially the right atrium and right ventricle. These adapt to handle that extra blood flow and start growing . This works so well that there are many people who don’t notice anything for decades. In the long run, the right atrium and the right ventricle suffer from the continuous overload. This will result in a reduced exertion level for the patient.
Treatment and aftercare
To prevent long-term problems, the opening is often closed at the age of 4-6 years. In that case, the right atrium and right ventricle will again decrease in size. Only if children have increased mucus production, such as in children with bronchitis, will it be decided to close the opening sooner.
Until recently, heart surgery was the only option to close the hole. Nowadays several ways have been found and. In some cases, a kind of umbrella can be brought from the vein in the groin to the heart and placed in front of the opening, but this is not always possible; if the child is not big enough, or the opening is too large or not in the middle, surgery is still necessary.
After closing the gap, the children’s future expectations are normal. However, a course of antibiotics is often continued for the first 6 months to prevent possible complications in the form of bacterial infections.