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VSD/ ASD

VENTRICULAR SEPTAL DEFECT (VSD)

It is a heart malformation present at birth. It can also be termed as congenital heart disease (CHD) as it is present from birth. A VSD heart has a hole in the septum between the two ventricles. This type of disorder can be approximated to be 1 in 500 babies. VSD is accounted for around 25 -35 % CHD.

How do VSDs cause problems?

When the heart pumps, the pressure generated while contraction by the left ventricle is much more than that generated by right ventricle. Blood will then be pushed through the shunted or VSD from left to right ventricle. In this procedure, the right ventricle has to an extra work to handle the extra blood volume. This affects the ability of heart in pumping properly. Under this high pressure, the lungs start getting more blood. This extra pressure leads to the permanent damage to the lungs.

  • Conventional Systems: this requires lesser effort on patient’s end as far as the maintenance is concerned. A minor surgical procedure is adopted for replacing the power source when it turns out.
  • Radiofrequency system: They are designed to sustain longer period therapy for highest output levels. Owing to the higher power capabilities, the radiofrequency system is suited for more complex processes with multi extremity pain. This requires patient to wear external power source in order to activate the stimulation.
  • Rechargeable Systems: This is the newest type of treatment. The patient holds himself responsible for charging the source. This rechargeable system runs longer than its conventional counterpart. A minor surgical procedure might be needed in order to replace power source.

Patient Selection Criteria

  • Patient must not be associated with any kind of malignancy
  • Patient must not have any major psychiatric disorder
  • Patient must be willing to stop any inappropriate drug prior to the implantation
  • Patient must not have any litigation
ATRIAL SEPTAL DEFECT (ASD)

Atrial septal defect means a hole in the septum which means hole in the wall between the atria. This defect causes the blood to flow through hole from left to right atrium. This pressure increases the blood volume in right atrium which therefore means more blood in lungs. If this defect is not treated well on time then this can cause serious problems in future namely weakening of heart muscles, atrial arrhythmias and pulmonary hypertension.

Treatment of ASD

In some cases, ASD may close at its own without treatment. The rate of spontaneous closure can be as high as 80% in first 18 months of life but an ASD present till the age of 3 can never close at its own.

  • Open Heart Surgery: Open heart surgery is not very common these days, however it is still considered to be a low risk surgery and effective. Surgeons treat the ASA depending on the size and shape of hole.
  • Transcatheter Device Closure: taking into consideration the size and shape of the septum involved, many ASDs can be closed effectively with the help of placing a device while cardiac catheterization. The device is inserted with the help of catheter and it covers the ASD by attaching to atrial septum. A catheter is thin, long tube which is directed in to the heart through large blood vessel in the groin.

Atrial Septal Defect Closure Results :

This is complication free procedure in over 99 % of the cases. Though Amplatzer device has been in use from a short time, but its success rate appears to be very high. After the ASD closure in childhood, the heart returns to normal size over a period of 6 months. Post surgery, there are no problems with physical activities. Regular follow ups are important and are advisable irrespective of closure mode.

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