Cardiovascular System - Atrial Septal Defects: Difference between revisions

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* Increasingly closure by a transcatheter device closure has been applied.
* Increasingly closure by a transcatheter device closure has been applied.
* Repair of atrial septal defects on the perfused beating heart (atrial septal defect size 2 cm - 4.5 cm) <ref><pubmed>19876418</pubmed></ref>
* Repair of atrial septal defects on the perfused beating heart (atrial septal defect size 2 cm - 4.5 cm) <ref><pubmed>19876418</pubmed></ref>
==International Classification of Diseases==
The International Classification of Diseases (ICD) World Health Organization's classification used worldwide as the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems. Within this classification "congenital malformations, deformations and chromosomal abnormalities" are (Q00-Q99) but excludes "inborn errors of metabolism" (E70-E90).
===Congenital malformations of the circulatory system (Q20-Q28)===
====Q21 Congenital malformations of cardiac septa====
Excl.: acquired cardiac septal defect (I51.0)
* Q21.0 Ventricular septal defect
* Q21.1 Atrial septal defect Coronary sinus defect Patent or persistent: foramen ovale ostium secundum defect (type II) Sinus venosus defect
* Q21.2 Atrioventricular septal defect Common atrioventricular canal Endocardial cushion defect Ostium primum atrial septal defect (type I)
* Q21.3 Tetralogy of Fallot Ventricular septal defect with pulmonary stenosis or atresia, dextroposition of aorta and hypertrophy of right ventricle. 
* Q21.4 Aortopulmonary septal defect Aortic septal defect Aortopulmonary window
* Q21.8 Other congenital malformations of cardiac septa Eisenmenger's defect Pentalogy of Fallot Excl.: Eisenmenger's complex (I27.8) syndrome (I27.8)
* Q21.9 Congenital malformation of cardiac septum, unspecified Septal (heart) defect NOS
:[[International_Classification_of_Diseases|'''ICD-10 Code''']]:  Q21.1 Atrial septal defect


==Cardiovascular Abnormalities==
==Cardiovascular Abnormalities==

Revision as of 01:22, 13 July 2012

Introduction

Atrial Septal Defect

Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomolies defects occuring in a number of different forms and more often in females.

  • patent foramen ovale- allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
  • ostium secundum defect
  • endocardial cushion defect involving ostium primum
  • sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
  • common atrium


Heart Abnormal: Tutorial Abnormalities | atrial septal defects | double outlet right ventricle | hypoplastic left heart | patent ductus arteriosus‎ | transposition of the great vessels | Tetralogy of Fallot | ventricular septal defects | coarctation of the aorta | Category ASD | Category PDA | Category ToF | Category VSD | ICD10 - Cardiovascular | ICD11


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Historic Embryology - Cardiovascular 
1902 Vena cava inferior | 1905 Brain Blood Vessels | 1909 Cervical Veins | 1909 Dorsal aorta and umbilical veins | 1912 Heart | 1912 Human Heart | 1914 Earliest Blood-Vessels | 1915 Congenital Cardiac Disease | 1915 Dura Venous Sinuses | 1916 Blood cell origin | 1916 Pars Membranacea Septi | 1919 Lower Limb Arteries | 1921 Human Brain Vascular | 1921 Spleen | 1922 Aortic-Arch System | 1922 Pig Forelimb Arteries | 1922 Chicken Pulmonary | 1923 Head Subcutaneous Plexus | 1923 Ductus Venosus | 1925 Venous Development | 1927 Stage 11 Heart | 1928 Heart Blood Flow | 1935 Aorta | 1935 Venous valves | 1938 Pars Membranacea Septi | 1938 Foramen Ovale | 1939 Atrio-Ventricular Valves | 1940 Vena cava inferior | 1940 Early Hematopoiesis | 1941 Blood Formation | 1942 Truncus and Conus Partitioning | Ziegler Heart Models | 1951 Heart Movie | 1954 Week 9 Heart | 1957 Cranial venous system | 1959 Brain Arterial Anastomoses | Historic Embryology Papers | 2012 ECHO Meeting | 2016 Cardiac Review | Historic Disclaimer

Some Recent Findings

  • Atrial septal defect devices used in the cardiac catheterization laboratory[1] "An atrial septal defect (ASD) is a hole in the atrium of the heart. There are 3 types of ASDs; sinus venosus (high in the atrial septum), secundum ASD (middle of septum), and ostium primum (low in the septum). The most common ASD is a secundum ASD. Secundum ASDs are caused by a failure of the atrial septum to close completely during the development of the heart. The most common reported symptoms are fatigue and shortness of breath. Most patients are found to have an ASD after evaluation for a murmur. All ASDs used to be repaired by open heart surgery. However, with advances in the cardiac catheterization lab and development of new devices, some secundum ASDs are able to be closed in the catheterization lab by an interventional cardiologist. There are various types of devices that may be used for closure of an ASD in the cardiac catheterization laboratory. This paper will address 2 of the devices most commonly used. Anticoagulation therapy will need to be followed for approximately 6 months and echocardiograms will need to be obtained at follow-up visits. Nurses have an important role in preparing and teaching the patient and family about the ASD closure procedure and follow-up care."

History

1941

ATRIAL SEPTAL DEFECT.[2]

"Patent foramen ovale and atrial (or auricular) septal defect (A.S.D.), though both characterised by an aperture in the atrial septum, are embryologically and pathologically different conditions."

Treatment

The surgical repair requires a cardiopulmonary bypass and is recommended in most cases of ostium secundum ASD, even though there is a significant risk involved. Ostium primum defects tend to present earlier and are often associated with endocardial cushion defects and defective mitral or tricuspid valves. In such cases, valve replacement may be necessary and the extended operation has a considerable chance of mortality.

  • Increasingly closure by a transcatheter device closure has been applied.
  • Repair of atrial septal defects on the perfused beating heart (atrial septal defect size 2 cm - 4.5 cm) [3]

International Classification of Diseases

The International Classification of Diseases (ICD) World Health Organization's classification used worldwide as the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems. Within this classification "congenital malformations, deformations and chromosomal abnormalities" are (Q00-Q99) but excludes "inborn errors of metabolism" (E70-E90).

Congenital malformations of the circulatory system (Q20-Q28)

Q21 Congenital malformations of cardiac septa

Excl.: acquired cardiac septal defect (I51.0)

  • Q21.0 Ventricular septal defect
  • Q21.1 Atrial septal defect Coronary sinus defect Patent or persistent: foramen ovale ostium secundum defect (type II) Sinus venosus defect
  • Q21.2 Atrioventricular septal defect Common atrioventricular canal Endocardial cushion defect Ostium primum atrial septal defect (type I)
  • Q21.3 Tetralogy of Fallot Ventricular septal defect with pulmonary stenosis or atresia, dextroposition of aorta and hypertrophy of right ventricle.
  • Q21.4 Aortopulmonary septal defect Aortic septal defect Aortopulmonary window
  • Q21.8 Other congenital malformations of cardiac septa Eisenmenger's defect Pentalogy of Fallot Excl.: Eisenmenger's complex (I27.8) syndrome (I27.8)
  • Q21.9 Congenital malformation of cardiac septum, unspecified Septal (heart) defect NOS
ICD-10 Code: Q21.1 Atrial septal defect

Cardiovascular Abnormalities

Data shown as a percentage of all major abnormalities based upon published statistics using the same groupings as Congenital Malformations Australia 1981-1992 P. Lancaster and E. Pedisich ISSN 1321-8352.

Heart defects and preterm birth are the most common causes of neonatal and infant death. The long-term development of the heart combined with extensive remodelling and post-natal changes in circulation lead to an abundance of abnormalities associated with this system.

A UK study literature showed that preterm infants have more than twice as many cardiovascular malformations (5.1 / 1000 term infants and 12.5 / 1000 preterm infants) as do infants born at term and that 16% of all infants with cardiovascular malformations are preterm. (0.4% of live births occur at greater than 28 weeks of gestation, 0.9% at 28 to 31 weeks, and 6% at 32 to 36 weeks. Overall, 7.3% of live-born infants are preterm)[4]

"Baltimore-Washington Infant Study data on live-born cases and controls (1981-1989) was reanalyzed for potential environmental and genetic risk-factor associations in complete atrioventricular septal defects AVSD (n = 213), with separate comparisons to the atrial (n = 75) and the ventricular (n = 32) forms of partial AVSD. ...Maternal diabetes constituted a potentially preventable risk factor for the most severe, complete form of AVSD." [5]

In addition, there are in several congenital abnormalities that exist in adults (bicuspid aortic valve, mitral valve prolapse, and partial anomalous pulmonary venous connection) which may not be clinically recognized.


References

  1. <pubmed>19737165</pubmed>
  2. <pubmed>18609869</pubmed>| PMC503458 | PDF
  3. <pubmed>19876418</pubmed>
  4. <pubmed>16322141</pubmed>
  5. <pubmed>11241431</pubmed>

Articles

<pubmed>22252195</pubmed> <pubmed>22219470</pubmed> <pubmed>22097699</pubmed> <pubmed>22066780</pubmed> <pubmed>21545985</pubmed>

Search Pubmed

Search Pubmed: Atrial Septal Defect

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Cite this page: Hill, M.A. (2024, March 28) Embryology Cardiovascular System - Atrial Septal Defects. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Cardiovascular_System_-_Atrial_Septal_Defects

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