Atrial septal defect is one among the commonest congenital heart disease .After years of controversy, there is consensus now , all significant ASDs need to be closed , at whatever age it is detected.
This rule does not apply to small ASDs without chamber right atrial and right ventricular dilatation. These defects and PFOs need not be closed .
Over the years , the controversy has shifted from Should we close ? to How to close ?
There are two options available : Device closure , Surgical closure
The following table compares the both treatment modalities
( Personal perspective )
Device closure is a complex, costly, often difficult and error prone cardiac procedure .It needs long term follow up and may carry a life long risk of major cardiac complication.It is useful only in selected subset of ASD patients. Surgical closure prevails over device closure in most situations.
Is this article has biased view against this emerging pediatric interventional procedure of ASD closure ?
It may appear so . But that is the reality as on 2009 !.May we hope technology evolves further and take our surgeons head on .