Atrial Septal Defect

What is an Artrial Septal Defect?

An Atrial Septal Defect (ASD) is a congenital heart defect. Congenital means present at birth. They occur early in pregnancy often before a mother even knows she is pregnant. A defect of the heart can vary in severity from a simple problem to a more serious abnormality. The heart has two upper chambers, the left atrium and the right atruim. These are the blood collection chambers of the heart. The right atrium receives un-oxygenated blood (blue blood, see diagram below) from the body and sends it to the right ventricle which pumps blood to the lungs to receive oxygen. The left atrium receives this oxygenated blood (red blood, see diagram below) back from the lungs and sends it to the left ventricle, which pumps the blood out of heart to the body. An ASD is a hole (an opening) in the wall or between these two collection chambers. This causes oxygen-rich blood to leak from the left side of the heart to the right side of the heart. This can cause more work for the heart and lungs since more blood is flowing through the right ventricle to the lungs. An ASD can sometimes be identified during a prenatal ultrasound but can be difficult to see. Many are not diagnosed until after birth.

What are the causes of ASD?

ASD is the second most common congenital heart defect and accounts for 10-15% of all congenital heart defects.

Version Date: June 28th, 2012

Some congenital heart defects may have a genetic link causing heart problems to occur more often in certain families. ASD may be associated with other heart defects. But most often an ASD occurs by chance and can happen to anyone.

What does this mean?

During pregnancy, an ASD is well tolerated by the baby as the baby does not need to use his/her lungs and the heart does not need to send blood to the lungs to pick up oxygen. The placenta and umbilical cord carries oxygen to the baby.

What other tests should we consider?

It is important to check the baby for other abnormalities. Further tests include a detailed ultrasound that is used to assess the babys other organs. A fetal echocardiogram, which is a detailed ultrasound of your babys heart, will also be done.

What will happen around the time of the babys birth?

An ASD can vary in size from very small to very large. Some small ASDs close on their own and need no treatment. If the hole is large, too much blood can flow to the lungs forcing the heart to over work, making it bigger. To prevent lung and heart problems, larger holes usually need to be corrected sometime after birth with surgery by applying a patch or by sewing the hole closed.

What does this mean for my babys future?

If there are no other abnormalities other than the ASD, the outlook for these children is excellent with normal growth, development, and life expectancy.

What do we do now?
You will meet with a doctor that specializes in high-risk obstetrics. A referral to a paediatric cardiologist (heart specialist for children) will be made to discuss with you the care the baby will need after birth. These doctors will discuss with you in detail your options for further testing, discuss with you test results and provide you with treatment options. They will be able to answer any questions you may have.

Where can I get more information?

The Childrens Hospital of Philadelphia Atrial Septal Defect (ASD) in Children http://www.chop.edu/service/cardiac-center/heart-conditions/atrial-septal-defect-asd.html

Version Date: June 28th, 2012

The Childrens Heart Institute Congenital Heart Defects: Atrial Septal Defect (ASD) http://childrensheartinstitute.org/educate/defects/asd-1.htm

Version Date: June 28th, 2012