About four people in every 100,000 have Atrial Septal Defect (ASD), which is a heart condition present from birth. An ASD is a hole, or similar defect, in the wall of the atrium, the upper chamber of the heart where the wall between the right and left atria does not close completely during fetal development.
In fetal circulation an opening normally exists between the two atria (the upper chambers of the heart) to allow blood to bypass the lungs. This opening usually closes about the time a baby is born to allow it to begin to breathe and circulate oxygen-enriched blood. If the opening persists beyond birth, an ASD results. The ASD allows blood to continue to flow from the left to the right atria.
When no other congenital defect coexists, symptoms may be absent, particularly in children. It may be discovered during a routine physical, and confirmed with an echocardiogram. For most other patients, symptoms typically appear by age 30.
With a small-to-moderate atrial septal defect, a person may live a normal life span without symptoms. Larger defects may cause disability by middle age because of increased blood flow and shunting of blood back into the pulmonary circulation.
If left untreated, an ASD can result in heart failure or stroke. Individuals with ASD may also develop complications including infective endocarditis (a bacterial infection of the heart), heart failure and an abnormally fast heart rhythm known as atrial fibrillation.
When symptoms are reported, they usually involve fatigue and shortness of breath. Other symptoms may include: frequent respiratory infections, difficulty breathing (dyspnea), shortness of breath with activity and the sensation of feeling heart beat (palpitations). Because most people have no symptoms, most ASDs are discovered incidentally during medical examinations. There is no known way to prevent the defect, but some of the complications can be prevented with early detection.
Surgical Repair of an Atrial Septal Defect
ASD repair may not require treatment if there are few or no symptoms, or if the defect is small. Surgical closure of the defect is recommended if the ASD is large or if symptoms occur.
The traditional "open" approach to ASD repair requires that the surgeon cut through the breastbone -- the body’s natural protective structure for the heart -- and pull back the ribs to access the heart. This approach can prolong healing time, increase risk of infection, serious complications and even mortality.
da Vinci® ASD Repair: A Less Invasive Procedure
If your doctor recommends surgical repair, you may be a candidate for a new, less invasive surgical procedure called da Vinci ASD Repair. This procedure uses a state-of-the-art surgical system designed to help your surgeon see vital anatomical structures more clearly and to perform a more precise operation.
For most patients, da Vinci Atrial Septal Defect Repair offers numerous potential benefits over traditional open-chest surgery, including:
Shorter hospital stay
Less pain and scarring
Less risk of infection
Less blood loss and fewer transfusions
Quicker return to normal activities
As with any surgery, these benefits cannot be guaranteed, as surgery is patient- and procedure-specific.