Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD) in Children
Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD) commonly known as hole-in-the-heart are among the most common heart defects with which children are born. The hole affects the wall of the heart that separates its four chambers. Diagnostic results of this heart defect can be scary for parents but it should be kept in mind that the underlying condition is now very much treatable, thanks to the ongoing advances in medical sciences.
In the human heart, the upper two chambers are called atria while the lower two chambers are called ventricles. The right chamber receives deoxygenated blood from the body and pumps it to the lungs for oxygenation while the left chambers receive oxygen-rich blood from the lungs which in turn pump it to the rest of the body.
In a healthy and normal heart, the wall (septum) separates the right chamber and left chamber of the heart and prevents the mixing of oxygenated and deoxygenated blood with each other. In case of septal defects, the blood may flow back and forth between the left and right side of the heart. Because of the hole in the atrial or ventricle wall, the heart cannot work efficiently because the lungs receive too much oxygenated blood making it difficult for them and the heart to work harder.
Read Also: Heart Disease In Children
What are Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD)?
Atrial Septal Defect (ASD) is a congenital heart defect present at birth. It is the hole in the septum (wall) between the heart’s upper two chambers. Ventricular Septal Defect (VSD) is also considered a congenital heart defect. It is a hole in the septum (wall) between the heart’s lower two chambers.
Symptoms of Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD):
While a very small hole in the heart may not cause any issues a larger hole can create problems and show symptoms.
Some of the symptoms of septal defects in babies may include:
- Abnormal heartbeat
- Excessive breathing
- Poor growth
- Trouble in eating
Some of the symptoms of septal defects in older children and adults may include:
- Heart palpitations
- Inability to exercise
- Shortness of breath
Screening and diagnosis of Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD):
Heart septal defects such as Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD) are generally diagnosed by a pediatrician through an echocardiogram or a bubble study.
Echocardiogram also known as the heart echo, is a kind of ultrasound performed to find out the flow of the blood through the heart. This test helps the cardiologist in diagnosing the location and size of the septal defect. Septal defects can also be diagnosed before birth through a fetal echocardiogram.
To diagnose a very tiny hole in the heart, the cardiologist can perform a bubble study test. In this test, the cardiologist will inject sterile water into a vein in the arm containing many microbubbles. This sterile water is then circulated towards the heart and will appear white in the ultrasound. The cardiologist can see the movement of bubbles with the blood through the heart. This procedure may require sedation and is generally performed on older children and adults.
Treatment of Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD):
It has been found that a septal defect does not always require treatment. A small hole in the heart should be monitored properly if it is not causing serious symptoms or lowering the child’s quality of life. Many of the small septal defects close on their own as a child grows. The closure of the hole takes place in the part of the septum that is all muscle.
Surgery may be required if the hole does not close on its own within the child’s first two years or if the hole is larger than 8 mm. Septal defects generally require treatment and can cause long-term effects like damage to the lungs.
The most common treatment methods used to treat septal defects are as follows:
Transcatheter repair also known as Transcatheter Device Closure is one of the procedures used to treat atrial septal defects. This procedure is performed by a pediatric interventional cardiologist who makes an incision in the groin area, inserts a catheter, and covers the hole in the heart with a small mesh patch that is passed through the catheter. Over time, the heart tissue grows over the patch.
Open Heart Surgery:
Open heart surgery is generally used to repair a ventricular septal defect. During the surgery, doctors and surgeons open up the chest area by opening the sternum (breastbone), and a patch is applied to the septal defect. The heart’s normal tissue will cover the patch with time.
Life after Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD):
Children generally have to go through a single surgery to correct septal defects. The patch used during the surgery stays in its place for the rest of the child’s life and the positive effects of septal defects can be seen right after the surgery. It has been observed that babies who were having trouble feeding before surgery, feed much better after surgery and gain weight more easily. This surgery also improves the activity level of the child. Proper monitoring and lifelong care may be required post the septal defect surgery.
Meet the specialists at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad
Dr. Yatin Arora is the Senior Cardiac and vascular Surgeon at Yashoda Hospital, Ghaziabad. Dr. Arora holds an M.Ch. from AIIMS, Delhi. With extensive teaching and surgical experience, he has contributed to publications and assisted in complex surgeries.
Dr. Ankur Agrawal is a Cardiothoracic and Vascular Surgeon at Yashoda Hospital & Research Centre, Ghaziabad. He has trained at AIIMS and specializes in adult & pediatric cardiac, thoracic, and vascular surgeries.