The atrial septal defect or ASD is a congenital heart defect, which looks like a hole between the two upper chambers of the heart – the right atrium and the left atrium. This allows the mixing of venous blood, poor in oxygen, which returns to the heart from the body (right atrium) and oxygenated blood coming from the lungs (left atrium). The degree of mixing largely depends on the size of the defect and the relative pressures in each atrium.
At the beginning of person’s life, blood from the left atrium mainly moves to the right atrium, causing an excessive flow of blood through the lungs. If this flow is sufficient, resistance to flow develops in the lungs, as a result of which venous blood begins to flow in the opposite direction, from the right atrium to the left atrium, and then into the body. This can lead to a condition called “cyanosis,” when blood is not oxygenated enough and enters the body, causing premature fatigue and congestive heart failure.
We cooperate with the leading Israeli cardiac surgeons, heads of cardiac surgery departments and research institutes, which have many years experience of ASD repair procedure.
Our cardiac surgeons perform atrial septal defect repair surgery at one of the biggest Israeli hospitals – Assuta.
Minor atrial septal defects can often be observed, without surgery, due to minimal flow. Large openings must be closed to prevent the irreversible effects of late excessive flow from left to right. ASD can be closed surgically by simple stitching or in the case of large openings with a graft of patient’s own tissue or synthetic material (for example, Dacron).
ASD repair procedure
The procedure requires the use of a cardiopulmonary bypass. This allows the surgeon to safely open the right atrium and gain access to the atrial septum in a relatively bloodless area. In some cases, the heart can also be stopped for 1 to 2 hours to facilitate repair. The ASD repair is in the range from relatively simple operations to more complex procedures, depending on the location, size and characteristics of ASD. The total duration of the operation is from 2 to 3 hours.
Although this approach provides excellent access to the heart, the complete healing of a postoperative wound can take several months, a long recovery period with significant activity limitations can also be long. Therefore, our surgeons, whenever possible, try to use minimally invasive methods of surgery.
Minimally invasive approach to atrial septal defect repair
Mini-thoracotomy is performed by a 4-centimeter incision through the right side of the chest between the ribs. Cardiopulmonary bypass is introduced using tubes placed in the main artery and veins on the right leg, after 3 cm the incision is placed in the right inguinal fold. The heart is stopped and the right atrium is opened to expose the atrial septal defect. At this point, specialized instruments are inserted through a small incision, and the surgeon eliminates the defect. After correction, the heart is closed and restarted. Cardiopulmonary bypass stops and stitches are applied to the incisions.
Related:
⇒ Leading Israeli cardiologists and cardiac surgeons
⇒ Atrial Septal Defect
⇒ Cardiology
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