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Suggest Treatment For Atrial Septal Defect In Children

Posted on Thu, 12 May 2016

Question: hi doctor, my child( 4year old male) is diagnosed with asd. before two months, the hole was smaller so that it could be managed by key hole surgery. but last day, after the echo, they said the hole becomes bigger, so they demand open heart surgery. is it possible for the hole become larger within months? if so, what are to be taken care of doctor?

Answered by Dr. Sumanth Amperayani (24 minutes later)

Brief Answer:
It can become larger - may need surgery

Detailed Answer:
Hi....if ASD is a small one it should have closed by now. If it has not closed and if it is becoming larger and as the kid is already 4 years old, he might require surgery.

Can you upload the report copy of the two echos please.

Reg - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (11 minutes later)

the report copy of previous one has been uploaded..the newer report mentioning about open heart havnt been given by the hospital authorities

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
I need th elatest copy too - old report report itself indicates closure

Detailed Answer:
Hi...I need the new report too. But the old report itself is an indication for closure as the ratio is 2:1.

Not all children with an atrial septal defect are candidates for surgery, which is only indicated for those children with clinically significant left-to-right shunting. In general, a pulmonary-to-systemic flow ratio of 1.5:1 or more is considered the principal indication for surgical repair.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (26 minutes later)

thank you doctor for the kind information, but as I mentioned earlier, the authorities didnt gave the report to us, rather they kept the record saying that the hole becomes larger so need open heart instead of key hole. so the ratio of 2:1 felt to be a serious concern?

Answered by Dr. Sumanth Amperayani (22 minutes later)

Brief Answer:
As the ratio is more than 1:5 it is of concern

Detailed Answer:
Hi....as the ratio is abkve 1:5 it is of concern and needs surgery please.

Regards - Dr. Sumanth

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar