Atrial septal defects

Summary Atrial septal defects are the third most common type of congenital heart disease. Included in this group of malformations are several types of atrial communications that allow shunting of blood between the systemic and the pulmonary circulations. Most children with isolated atrial septal def...

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Bibliographic Details
Published in:The Lancet (British edition) 2014-05, Vol.383 (9932), p.1921-1932
Main Authors: Geva, Tal, Prof, Martins, Jose D, MD, Wald, Rachel M, MD
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiac arrhythmia
Cardiac Catheterization - methods
Cardiology. Vascular system
Cardiovascular disease
Cardiovascular diseases
Catheters
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
Defects
Electrocardiography
Female
General aspects
Heart
Heart Septal Defects, Atrial - complications
Heart Septal Defects, Atrial - diagnosis
Heart Septal Defects, Atrial - physiopathology
Heart Septal Defects, Atrial - surgery
Hemodynamics - physiology
Humans
Hypertension
Internal Medicine
Life expectancy
Medical equipment
Medical sciences
Mutation
Older people
Pregnancy
Pregnancy Complications, Cardiovascular
Prognosis
Risk Factors
Septal Occluder Device
Transplants & implants
Treatment Outcome
Vascular diseases
Veins & arteries
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Summary:Summary Atrial septal defects are the third most common type of congenital heart disease. Included in this group of malformations are several types of atrial communications that allow shunting of blood between the systemic and the pulmonary circulations. Most children with isolated atrial septal defects are free of symptoms, but the rates of exercise intolerance, atrial tachyarrhythmias, right ventricular dysfunction, and pulmonary hypertension increase with advancing age and life expectancy is reduced in adults with untreated defects. The risk of development of pulmonary vascular disease, a potentially lethal complication, is higher in female patients and in older adults with untreated defects. Surgical closure is safe and effective and when done before age 25 years is associated with normal life expectancy. Transcatheter closure offers a less invasive alternative for patients with a secundum defect who fulfil anatomical and size criteria. In this Seminar we review the causes, anatomy, pathophysiology, treatment, and outcomes of atrial septal defects in children and adult patients in whom this defect is the primary cardiac anomaly.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(13)62145-5