ASD VSD Closure
Signs and symptoms are related to the type and severity of the heart defect. Symptoms frequently present early in life, but it's possible for some CHDs to go undetected throughout life. Some children have no signs while others may exhibit shortness of breath, cyanosis, syncope, heart murmur, under-developing of limbs and muscles, poor feeding or growth, or respiratory infections. Congenital heart defects cause abnormal heart structure resulting in production of certain sounds called heart murmur. These can sometimes be detected by auscultation; however, not all heart murmurs are caused by congenital heart defects.
Congenital heart defects are associated with an increased incidence of some other symptoms, together being called the VACTERL association:
* V-Vertebral Anomalies
* A-Anal Atresia
* C-Cardiovascular Anomalies
* T-Tracheoesophageal fistula
* E-Esophageal Atresia
* R-Renal Anomalies
* L-Limb Defects
Ventricular septal defect (VSD), atrial septal defects, and tetralogy of Fallot are the most common congenital heart defects seen in the VACTERL association. Less common defects in the association are truncus arteriosus, and transposition of the great arteries.
The cause of congenital heart disease may be either genetic or environmental, but is usually a combination of both.
Most of the known causes of congenital heart disease are sporadic genetic changes, either focal mutations or deletion or addition of segments of DNA. Large chromosomal abnormalities such as trisomies 21, 13, and 18 cause about 5-8% of cases of CHD, with trisomy 21 being the most common genetic cause. The genes regulating the complex developmental sequence have only been partly elucidated. Some genes are associated with specific defects. A number of genes have been associated with cardiac manifestations. Mutations of a heart muscle protein, α-myosin heavy chain (MYH6) are associated with atrial septal defects. Several proteins that interact with MYH6 are also associated with cardiac defects. The transcription factor GATA4 forms a complex with the TBX5 which interacts with MYH6. Another factor, the homeobox (developmental) gene, NKX2-5 also interacts with MYH6. Mutations of all these proteins are associated with both atrial and ventricular septal defects; In addition, NKX2-5 is associated with defects in the electrical conduction of the heart and TBX5 is related to the Holt-Oram syndrome which includes electrical conduction defects and abnormalities of the upper limb. Another T-box gene, TBX1, is involved in velo-cardio-facial syndrome DiGeorge syndrome, the most common deletion which has extensive symptoms including defects of the cardiac outflow tract including tetralogy of Fallot.
Sometimes CHD improves without treatment. Other defects are so small that they do not require any treatment. Most of the time CHD is serious and requires surgery and/or medications. Medications include diuretics, which aid the body in eliminating water, salts, and digoxin for strengthening the contraction of the heart. This slows the heartbeat and removes some fluid from tissues. Some defects require surgical procedures to restore circulation back to normal and in some cases, multiple surgeries are needed. Interventional cardiology now offers patients minimally invasive alternatives to surgery. Device closures can now be performed with a standard transcatheter procedure using a closure device mounted on a balloon catheter.
Most patients require life-long specialized cardiac care, first with a pediatic cardiologist and later with and adult congenital cardiologist. There are more than 1.8 million adults living with congenital heart defects.
A catheterization laboratory or cath lab is required for treatment of congenital cardiac defects like ASD and VSD closure. Sometimes surgery is also required for the treatment of these diseases. Not all hospital having cath lab have a good Cardiac OT backed by experienced Cardiac surgeons and Cardiac Anaesthetists. One must check the status of all the cardiac equipments before deciding on the treatment.
Best Hospitals / Doctors for this procedure
Since the congenital heart diseases are mostly found in children a good paediatric interventional cardiologist is best suited for the treatment of these diseases. For Best opinion you can consult Dr Jagmeet S Soin, Dr Monil Kadian or Dr Suresh Sharma.
Dr Jagmeet S Soin
MBBS (AIIMS), MD, FACC, FACP, FACNP
US Board Certified
Dr Jagmeet S Soin is an alumini of 1967 batch of All India Institute of Medical Sciences New Delhi, India. Dr Soin has an experience of over 45 years working in some of the top hospitals in USA like The Johns Hopkins Medical Centre and Boston City Hospital (Tufts University ). He is considered to be the pioneer in application of nuclear medicine in cardiac diagnostics. Dr Soin is one of the few internists and nuclear medicine physician in India.
Dr Monil Kadian
MBBS, MD (Medicine), Fellowship In Cardiology From John Hopkins Medical Centre, USA
Dr Monil Kadian is a highly trained cardiologist and heart specialist in Gurgaon, Delhi (NCR) India. Dr Monil has experience in treating various heart related problems like hypertension or blood pressure, chest pain, high cholestrol levels, breathing difficulty, tiredness and dysnea. Dr Kadian has special interest in medical and preventive cardiology.
He has done special training and fellowship in cardiology from John Hopkins Medical Centre USA which is considered as one of the best hospitals for training in cardiology.