An atrial septal defect is a congenital abnormality of the upper chamber of the heart. This defect is present from the time of birth where the wall between the left and right atria doesn’t close completely. In the fetal stage, there is an opening between the two atria of the upper two chambers for the blood flow to the lungs but this opening generally closes by the time of birth. If ASD is persistent it is called a shunt. Every 4 people in 100,000 have a case of ASD and these people have an increased risk of multiple complications like infective endocarditis, stroke and heart failure.
ASD requires no treatment if symptoms like frequent respiratory infections in children, shortness in breathing and difficulty breathing are not persistent, this generally happens if the defect is small or of moderate size. Bigger defects of middle-aged people with the symptoms are treated with surgical closure. Newer treatment methods also involve the use of a closure device through the use of catheters. This device called the Amplatz device is placed across the ASD to close the defect. This process though is new and is not applicable to all the patients.
People from more than 20 countries including the UK, US, and Australia travel to India for treatment of ASD because of its efficient and robust healthcare services in comparison to developed countries. ASD surgery in India can cost from $15000-$20000 depending on the type of defect and treatment, whereas in the USA it costs $64,000-$70,000 for ASD surgery.
30
Total Days
In Country
2 No. Travelers
7 Day in Hospital
23 Days Outside Hospital
Treatment cost starts from
USD 5000
Hospitals
Holes in the heart are a type of congenital heart disease. Ventricular septal defect (VSD) and atrial septal defect (ASD) are the two most common congenital defects that may affect an individual. These occur due to structural malformation in the walls of the heart when these are developing at the fetal stage. ASD and VSD can be repaired and closed as soon as they are identified or right after birth. ASD is the hole in the septa that divides the two atrium and VSD refers to the hole in the ventricular walls. The holes allow the reverse flow of blood, thus, facilitating the mixing of pure and impure blood.
Typically, medications are administered to see whether ASD or VSD closes on its own. In case the defect does not close on its own and the individual continues to experience atrial septal defect symptoms such as breathing difficulties, heart murmurs, shortness of breath, and respiratory infections, then a surgery is recommended. The surgical procedure for atrial septal defect repair and ventricular septal defect treatment are almost the same, except the fact that different parts of the heart are targeted during the surgery.
Two different types of approaches can be used for ASD and VSD repair or closure, depending on the experience of the surgeon, the overall health of the patient, and certain other factors. The first is open-heart surgery and the second one is cardiac catheterization. Irrespective of the approach used, the patient is administered a general anesthetic so that he or she does not feel any pain and is asleep during the procedure.
The main surgical approach used to repair or close ASD or VSD is open-heart surgery. It is conducted by making an incision in the chest and using surgical instruments to open the chest to gain access to the heart. The heart is then put on bypass, which involves connecting it to a machine that pumps blood to the body during the surgery. For the same reason, it is also known as the heart-lung bypass machine. The surgeon then repairs the hole by closing it with sutures or by placing a biological patch on it that mixes with the muscle. Once the hole is repaired, the chest is then closed and the incision site is closed with sutures.
It is a minimally invasive procedure conducted using a catheter, which is inserted into the blood vessel of the groin. The catheter is then guided up to the heart and mesh material is placed over the hole through the catheter to close the defect. Once the repair is made, the catheter is removed.
Within a period of 6 months, normal tissues start growing in and around the mesh. Only a needle puncture is made in this procedure and hence this is less invasive as a procedure. This procedure is usually successful until and unless the hole is too large and only an open surgery can solve the problem.
The patient will be transferred to the intensive care unit (ICU) for a day or so for continuous monitoring. Antibiotics will be administered to the patient to prevent infections such as endocarditis. Regular checkups will follow for a while to ensure that the hole gets closed properly. To prevent the formation of blood clots, the patient may be given aspirin. Apart from all these, for the first few months, activities will be kept limited till that patient is fit enough to handle physical exertion.
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