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Management of Atrial septal defect : Device closure lagging behind surgical closure !

Posted May 12 2009 4:00pm

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

asd closure device www.drsvenkatesan.com

asd closure www.drsvenkatesan.com

The following table compares the both treatment  modalities

( Personal perspective )

asd device closure 4

Final message

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 .

In science ,  one  needs to be right  not polite !

Reference

Aortic erosion following ASD closure

http://content.onlinejacc.org/cgi/content/full/45/8/1213

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