Atrial Septal Defect (ASD) Repair
An atrial septal defect (ASD) is a hole in the wall between the two upper chambers of your heart (atria). The condition is present at birth (congenital).
Small defects may never cause a problem and may be found incidentally. It's also possible that small atrial septal defects may close on their own during infancy or early childhood.
Large and long-standing atrial septal defects can damage your heart and lungs. An adult who has had an undetected atrial septal defect for decades may have a shortened life span from heart failure or high blood pressure that affects the arteries in the lungs (pulmonary hypertension). Surgery may be necessary to repair atrial septal defects to prevent complications.
It's not known why atrial septal defects occur, but congenital heart defects appear to run in families and sometimes occur with other genetic problems, such as Down syndrome. If you have a heart defect, or you have a child with a heart defect, a genetic counselor can estimate the odds that any future children will have one.
Some conditions that you have or that occur during pregnancy may increase your risk of having a baby with a heart defect, including:
- Rubella infection. Becoming infected with rubella (German measles) during the first few months of your pregnancy can increase the risk of fetal heart defects.
- Drug, tobacco or alcohol use, or exposure to certain substances. Use of certain medications, tobacco, alcohol or drugs, such as cocaine, during pregnancy can harm the developing fetus.
- Diabetes or lupus. If you have diabetes or lupus, you may be more likely to have a baby with a heart defect.
- Obesity. Being extremely overweight (obese) may play a role in increasing the risk of having a baby with a birth defect.
- Phenylketonuria (PKU). If you have PKU and aren't following your PKU meal plan, you may be more likely to have a baby with a heart defect.
A small atrial septal defect may never cause any problems. Small atrial septal defects often close during infancy.
Larger defects can cause serious problems, including:
- Right-sided heart failure
- Heart rhythm abnormalities (arrhythmias)
- Increased risk of a stroke
- Shortened life span
Less common serious complications may include:
- Pulmonary hypertension. If a large atrial septal defect goes untreated, increased blood flow to your lungs increases the blood pressure in the lung arteries (pulmonary hypertension).
- Eisenmenger syndrome. Pulmonary hypertension can cause permanent lung damage. This complication, called Eisenmenger syndrome, usually develops over many years and occurs uncommonly in people with large atrial septal defects.
Many babies born with atrial septal defects don't have associated signs or symptoms. In adults, signs or symptoms may begin around age 30, but in some cases signs and symptoms may not occur until decades later.
Atrial septal defect signs and symptoms may include:
- Shortness of breath, especially when exercising
- Swelling of legs, feet or abdomen
- Heart palpitations or skipped beats
- Heart murmur, a whooshing sound that can be heard through a stethoscope