Excelsior Correspondent
REASI, May 29: A 34-year-old man with a hole in his heart was treated successfully without surgery at Narayana Hospital, Kakrayal, Katra.
The patient with exertional breathlessness and palpitations for 3 months duration was brought in the Hospital. After thorough examination and investigations, a diagnosis of Large Ostium Secundum ASD with Mild PAH was made. Transesophageal echocardiography (TEE) showed dilated RA and right ventricle (RV), moderate tricuspid regurgitation, pulmonary artery systolic pressure of 35 mmHg, 22 mm ostium secundum ASD, with inadequate aortic rim.
The patient was advised for either open heart surgery with patch or closure of the hole using the groin i.e. percutaneous transcatheter device closure somewhat similar to angiography. Using Groin (Femoral vein) as access, the catheter was advanced across the defect into the LA; and 26 mm Amplatzer ASD device was released across the defect and the hole was closed.
Post procedural TEE showed the device in situ with no residual leaks/shunt. The patient made an uneventful post procedure recovery and was discharged home within 48 hrs of admission. Transthoracic echocardiography (2D Echo) was performed prior to discharge and was normal.
Explaining about the case, Dr Sushant Kumar, Senior Consultant Cardiologist said that the incidence of isolated ASD has been estimated at 1:1,500 live births, which is about 6% to 10% of all varieties of congenital heart disease. Atrial septal defect (ASD) is characterized by a defect in the interatrial septum (Hole in the heart), allowing pulmonary venous return to pass directly from the left atrium (LA) to the right atrium (RA).
The traditional method of closure has been surgical, which has been practiced for more than 50 years. With advancement in surgical techniques practice has moved to minimal invasive surgical approach, including minimal skin incisions, reduced opening of the thoracic cage thus allowing faster rehabilitation but still requires 4-5 days of hospital stay with due surgical procedure risk.
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