Atrial Septal Defect (ASD): Difference between revisions

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==Atrial septal defect (ASD)==
==Atrial septal defect (ASD)==


In an atrial septal defect (ASD), a hole in the atrial septum is oxygen-rich blood that is flowing from LA to RV. The RA, RV and ultimately the lungs, therefore there is more volume of blood to process. ASD is a volume load on the RV.
In an atrial septal defect (ASD), a hole in the atrial septum is flowing oxygen-rich blood from LA to RV. The RA, RV and ultimately the lungs, therefore has more volume of blood to process. ASD is the volume load on the RV.


[[Image: |Video]]
[[Image: |Video]]
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{| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="400px"
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|colspan="3"|'''ASD is to be divided into four types:'''
!colspan="2"|ASD is to be divided into four types:
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!Type  
!Type  
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ASD can manifest at any age . An ASD comes in 9 % of all congenital heart defects , but for the most common congenital heart disease that often only reflected ( 30 % ) in adulthood .
ASD can manifest at any age. An ASD comes in 9% of all congenital heart defects, but for the most common congenital heart disease often only reflects (30%) in adulthood.


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{| class="wikitable" cellpadding="0" cellspacing="0" border="0"
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|colspan="2"|'''Most common ASD'''
!colspan="2"|Most common ASD
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|ASD II  
|ASD II  
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|Rare
|Rare
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==Patent Foramen Ovale (PFO)==
==Patent Foramen Ovale (PFO)==


A patent foramen ovale , abbreviated to PFO , has a functional defect in the atrial septum, in contrast to an ASD that has an anatomical defect. The septum primum and septum secundum develop from different edges in the embryonic atria . However , the septum secundum does not form a closed portion , there always remains an opening between the two septa. At birth, the inter- atrial pressure is changed and to be pressed against each other , the two septa . In 15-35 % of the population, there still remains a small opening . A PFO is in fact an incomplete fusion of the septum primum and septum secundum .
A patent foramen ovale, abbreviated to PFO, has a functional defect in the atrial septum, in contrast to an ASD that has an anatomical defect. The septum primum and septum secundum develop from different edges in the embryonic atria. However, the septum secundum does not form a closed portion, there always remains an opening between the two septa. At birth, the inter-atrial pressure is changed and is pressed against the two septa. In 15-35% of the population, there still remains a small opening. A PFO is in fact an incomplete fusion of the septum primum and septum secundum .


A PFO is involved with a number of other pathologies such as cerebrovascular accident ( CVA ) , Transient Ischemic Attack ( TIA ) , Caisson Disease ( Decompression sickness among divers ) , Platypneu - orthodeoxiesyndroom and Migraine . There is a direct relationship between the size of the shunt and the risk of stroke .
A PFO is involved with a number of other pathologies such as cerebrovascular accident (CVA), Transient Ischemic Attack (TIA) , Caisson Disease (Decompression sickness among divers) , Platypneu-orthodeoxiesyndrom and Migraine. There is a direct relationship between the size of the shunt and the risk of stroke .


A PFO can be demonstrated with the aid of contrast by means of a saline solution . There is a PFO if within three cardiac cycles to see a crossing from right to left after administration of contrast.
A PFO can be demonstrated with the aid of [[Saline Solution|contrast]] by means of a saline solution. There is a PFO if within three cardiac cycles you see a crossing from right to left after administration of contrast.


The number of bubbles in one frame can be categorized in size of opening:
The number of bubbles in one frame can be categorized in size of opening:
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|colspan="2"|'''Size of PFO'''
!colspan="2"|Size of PFO
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|Narrow opening  
|Narrow opening  
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|Video
|Video
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!Crossing contrast to PFO <cite>2</cite>
!Crossing contrast to PFO <cite>1</cite>
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|colspan="2"|'''Considerations'''
!colspan="2"|Considerations
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|Localization of defect
|Localization of defect
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Click here for Qp / Qs calculation.
Click [http://csecho.ca/cardiomath/?eqnHD=echo&eqnDisp=qpqsecho '''here'''] for Qp/Qs calculation.


Example of ASD
===Example of ASD===
 
Large ASD type II contrast crossing at ASD type II
 
ASD closure


Closure of ASD occurs with Closure Device. Endocardial tissue grows over the device over .
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|Video
|Video
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!Large ASD type II
!Contrast crossing at ASD type II
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Source : EC Cheriex , " Left atrium and investigated ," Hamer / Pieper , ' Practical echocardiography , (2006 ) , 1st edition 2nd edition, Wood , Bohn Stafleu of Loghum , p.42 -53 .
===ASD closure===
 
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|Video
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!Closure of ASD occurs with Closure Device. Endocardial tissue grows over the device. <cite>2</cite>
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==References==
==References==
<biblio>
<biblio>
#1
#1 pmid=21078836
#2 pmid=21078836
#2 EC Cheriex, "Left atrium and investigated", Hamer/Pieper, "Practical echocardiography", (2006), 1st edition 2nd edition, Wood, Bohn Stafleu of Loghum, p.42-53.
#3 [http://csecho.ca/cardiomath/?eqnHD=echo&eqnDisp=qpqsecho|Pulmonary-Systemic Flow Ratio (Qp/Qs)]
</biblio>
</biblio>
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