Atrial septal defect indications for surgical repair in adults: Difference between revisions
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The Qp/Qs ratio can change as the disease progresses. Due to this it has been recommended to have a echocardiography every 2-3 years in asymptomatic patients. | The Qp/Qs ratio can change as the disease progresses. Due to this it has been recommended to have a echocardiography every 2-3 years in asymptomatic patients. | ||
* '''Special conditions''' | |||
[[ACC/AHA guidelines for reproduction in patients with atrial septal defect|ACC/AHA guidelines for reproduction]] | |||
==References== | ==References== | ||
Revision as of 16:09, 23 August 2011
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Atrial Septal Defect Microchapters | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [[4]]
Overview
Indications for atrial septal defect in adults
1) Development of symptoms
- Development and worsening of symptoms such as shortness of breath, exercise intolerance, fatigue, swelling of feet and ankle or abdomen (suggesting right sided heart failure), recurrent respiratory infections along with echocardiographic abnormalities are an indication for repair.
- Arrrhythmias as an isolated symptom can occur in 1 out of 5 adults patients with atrial septal defects. The surgical closure for patients presenting only with arrhythmia is controversial as not much benefit could be derived even after surgery.
2) Size and amount of blood shunting across the defect
Size and amount of blood shunting across the defect serve as a good indicator of the progression and worsening of the disease. The pulmonary-to-systemic flow ratio Qp/Qs gives a good idea of the shunting. Cardiac catheterization gives more accurate diagnosis of Qp/Qs, however echocardiography is more commonly used as it is convenient, non-invasive and cheap.
- The American Heart Association has recommended a threshold Qp/Qs ≥1.5:1 [1]
- The Canadian Cardiac Society recommended a threshold Qp/Qs >2:1, or >1.5:1 in the presence of reversible pulmonary hypertension [2].
The Qp/Qs ratio can change as the disease progresses. Due to this it has been recommended to have a echocardiography every 2-3 years in asymptomatic patients.
- Special conditions
ACC/AHA guidelines for reproduction
References
- ↑ Driscoll D, Allen HD, Atkins DL, Brenner J, Dunnigan A, Franklin W; et al. (1994). "Guidelines for evaluation and management of common congenital cardiac problems in infants, children, and adolescents. A statement for healthcare professionals from the Committee on Congenital Cardiac Defects of the Council on Cardiovascular Disease in the Young, American Heart Association". Circulation. 90 (4): 2180–8. PMID 7923709.
- ↑ Therrien J, Dore A, Gersony W, Iserin L, Liberthson R, Meijboom F; et al. (2001). "CCS Consensus Conference 2001 update: recommendations for the management of adults with congenital heart disease. Part I.". Can J Cardiol. 17 (9): 940–59. PMID 11586386.
External links
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