An atrialseptal defect (ASD) is a hole in the wall between the two upper chambers of your heart. The condition is present from birth (congenital).

1. Non Surgical intervention in ASD
and VSD

2. ASD
ASD

3. Atrial Septal Defect (ASD)

4. ASD
• An atrialseptal defect (ASD) is a hole in the wall between the two
upper chambers of your heart.
• The condition is present from birth (congenital).
• Smaller atrialseptal defects may close on their own during infancy or
early childhood.
• Large and long-standing atrialseptal defects can damage your heart
and lungs. An adult who has had an undetected atrialseptal defect
for decades may have a shortened life span from heart failure or
high blood pressure in the lungs. Intervention is usually necessary
to repair atrialseptal defects to prevent complications.

5. Causes of Atrial Septal Defect (ASD)
• Doctors know that heart defects present at birth (congenital) arise
from errors early in the heart development, but there is often no
clear cause. Genetics and environmental factors may play a role.
• An atrialseptal defect allows freshly oxygenated blood to flow from
the left upper chamber of the heart (left atrium) into the right upper
chamber of the heart (right atrium). There it mixes with
deoxygenated blood and is pumped to the lungs, even though it is
already refreshed with oxygen.
• If the atrialseptal defect is large, this extra blood volume can overfill
the lungs and overwork the heart. If not treated, the right side of the
heart eventually enlarges and weakens. In some cases, the blood
pressure in your lungs increases as well, leading to pulmonary
hypertension.

6. Symptoms of Atrial Septal Defect
(ASD)
• Many babies born with atrialseptal defects do not have
signs or symptoms. In adults, signs or symptoms may
not develop until age 30 or later.
• Your doctor may first uncover an atrialseptal defect
during a regular checkup while listening to your heart
using a stethoscope. Hearing a heart murmur may signal
a hole in your heart.
• Atrialseptal defects are often found when an ultrasound
exam of the heart (echocardiogram) is done for another
reason.
• Signs and symptoms of atrialseptal defects develop once
damage occurs to the heart and lungs. Infants with larger
atrialseptal defects may have poor appetites and not
grow as they should. Adults and infants may have signs
of heart failure or arrhythmias.

7. When to seek medical advice for
Atrial Septal Defect (ASD) :
Poor appetite Failure to gain
weight
2
1
Bluish
Shortness of discoloration of
2
2
breath the skin
Easy tiring
Swelling of 2
skipped beats
2
legs, feet or
abdomen

8. Morphology
MORPHOLOGY
Types of ASD:
Ostium primum
Ostium secundum
Sinus venosus
Coronary sinus defects
↑Left to right shunt:
* left ventricular compliance↓
* left atrial pressure ↑

10. Percutaneous ASD closure
• Percutaneous closure of an ASD is
indicated for the closure of
secundum ASDs with a sufficient rim
of tissue around the septal defect so
that the closure device does not
impinge upon the SVC, IVC, or the
tricuspid or mitral valvs.
• The Amplatzer Septal Occluder
(ASO) is commonly used to close
ASDs. The ASO consists of two self-
expandable round discs connected
to each other with a 4 mm waist,
made up of 0.004–0.005´´ Nitinol
wire mesh filled with Dacron fabric.
• Percutaneous closure is the method
of choice in most centres.

11. VSD
VSD

12. Morphology
MORPHOLOGY
Four components of Septum:
Membranous, inlet, trabecular, outlet (conal,infundibular) part.
Types of VSD :
Muscular VSD
Membranous VSD
Doubly committed subarterial VSD

15. Pathophysiology
PATHPHYSIOLOGY
Shunt Qp/Qs P/A systolic
pressure ratio
Restrictive Small 1~1.4 <0.3
VSD
Moderately Moderat 1.4~2.2 0.3~0.66
restrictive VSD e
Nonrestrictive Large >2.2 >0.66
VSD
Eisenmenger Right to <1 1
VSD left

17. Coarc Stent
Repair

18. THE FUTURE
IMPROVED
CONTRAST
AGENTS
Interventional
Real time 3-D imaging
cath
Improved Accuracy for
Repair of Complex CHD
Repair of Complex
CHD

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