Is surgery necessary in the case of an atrial septal defect?

Question

Hello doctor,

I am a 26-year-old male. I have undergone an echocardiogram and a transesophageal echocardiogram. The results indicate that I have an atrial septal defect (ASD) measuring 30x28 mm with a left-to-right shunt (2:1). The pulmonary vein and inferior vena cava rim are unclear. My heart function is good, but I have mild pulmonary arterial hypertension (PAH), no heart failure (HF), normal sinus rhythm (SR), and preserved cardiac function (FCI).

My cardiologist suggested open-heart surgery to correct the ASD, while another doctor mentioned that a catheter procedure was not suitable for my condition. Is this a dangerous situation? Is surgery necessary? What happens if it is not treated?

Additionally, I have had a chronic cough for the past six months. A respiratory doctor stated that it was an allergic symptom. Is there any connection between my cough and the ASD?

I am very worried, and I would appreciate your guidance and advice.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed the reports (attachment removed to protect patient identity). Based on the findings, surgical closure of the atrial septal defect (ASD) is recommended. Device closure is not suitable due to inadequate rims to secure the device, increasing the likelihood of it slipping. Therefore, surgery is necessary and must be performed. If the surgery is not done, irreversible damage to the heart and lungs may occur, although it has not yet happened. While it is not an emergency, it would be advisable to have the surgery within the next six months.

Your respiratory symptoms are likely related to the ASD, resulting from increased pulmonary blood flow. You should be prescribed diuretics, such as Torasemide and Spironolactone, to be taken in the morning at 8 AM by your specialist, which should hopefully alleviate your respiratory issues. This medication should be continued until the surgery.

I hope this helps you.

Answer 2

Hello,

Welcome back to icliniq.com.

No, you should not ignore the surgery. It is necessary for a better outcome. If you do not proceed with it, the condition may become inoperable in a few years, leading to a reduced life expectancy. Additionally, your quality of life could be significantly impaired 10 to 15 years down the line. Therefore, it is important to have the surgery.

Recovery will take two to four weeks, and you will be able to resume all activities, including going to the gym. Sternal straps are typically not removed and usually do not cause major problems, although some patients may experience pain. However, these are not reasons to avoid the surgery.

This condition is treatable at the moment and should be addressed without excessive stress.

Thanks and regards.