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Chapter-162 Atrial Septal Defect in Adults: Management Approach New Dimension

BOOK TITLE: CSI: Cardiology Update 2014

Author
1. Mishra Smita
ISBN
9789351526186
DOI
10.5005/jp/books/12415_163
Edition
1/e
Publishing Year
2015
Pages
9
Author Affiliations
1. Escorts-Fortis Health Care, New Delhi, India, smi1@rediffmail.com, Escorts-Fortis Health Care, New Delhi, India, Jaypee Hospitals, Noida, Uttar Pradesh, India, Jaypee Hospital, Noida, Uttar Pradesh, India, Fortis Escorts Heart Institute, New Delhi, India, Fortis Escorts Health Care, New Delhi, India, Manipal Hospital, Holy Family Hospital, New Delhi, India, Manipal Hospital, New Delhi, India, Jaypee Group of Hospitals, Noida, Consultant, Holy Family Hospital, New Delhi, India
Chapter keywords
PVRI, ASD, TEE, CT scans, MRI, ECG, chest X-ray, echocardiography, axillary incision, anesthesia

Abstract

The principle of ASD based on ASD closure in infant, closure in high PVRI group and use of pre and postpulmonary vasodilators, choice of procedure and choice of devices and also associated with syndromes. Pharmacological management manage the RV dysfunction and failure, arrhythmia, pulmonary hypertension, thromboembolism and LV dysfunction. Catheter intervention in ASD shows the true septum is restricted in area to the oval fossa and the anterior rim of the fossa ovalis and deficiency of septum primum results into ASD secundum. It can be evaluated by TEE, CT scans, MRI, ECG, chest X-ray and echocardiography. For ASO, the catheter procedure done under the general anesthesia. Surgery of ASD includes trans-xiphoid, right sub-mammary mini-thoracotomy, mini-sternotomy and axillary incision. Outcome of atrial septal defect closure associated with possible complications: hemorrhage, pain, nausea, vomiting, nickel allergy and thromboembolism. In addition, it describes the expanding indications of ASD closure in adults, remodeling of heart after intervention pregnancy in ASD operated or not in presence of severe PAH.

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