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Suggest treatment for ostium secundum in children

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Posted on Wed, 25 May 2016
Question: My daughter aged 1 yrs and 6 months old was diagnosed with ostium secundum asd at the age of 1 months with size 6mm,dilated RA/RV.Her 8 months old echo report says size of 14*18mm,Dilated RA/RV,TR-QV-30mmhg,Mild PAH,she is on Furoped 0.4ml twice daily and Altactone tab 0.25mg(1/4 Twice daily).Her 1 yrs old echo report says size 10-13mm,Dilated RA/RV,TR-QV-30mmhg,Mild PAH.Her 1 yrs & 4 months old echo report says Size 17mm,Dilated RA/RV,TR-QV-16mmhg,No PAH.Her Dr has stop the furoped and altactone Tab and given new medicine Lasilactone tab 50mg(1/4 once daily) and advise for device closure later on.Why her Dr are not willing to do now?And is the hole increasing or decreasing?
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Answered by Dr. Diptanshu Das (51 minutes later)
Brief Answer:
The size is likely to stay constant.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone very carefully through the details provided and have also checked the attachments. The hole size is likely to remain the same and even though there is difference in measured sizes, it just seems to be due to difference in measurements; I would not consider the size to vary. The hole in the heart is causing blood to flow from the left (from where the blood goes to the body) to the right (from where the blood goes to the lungs), thus leading to enlargement or dilatation of the right chambers while the blood overload on the lungs is leading to increase in the blood pressure in lungs (Pulmonary arterial hypertension or PAH). This would slowly be progressive and looking at the size, it does not appear to me that the hole will close on its own. But still the doctors wish to wait and watch (because certain holes do reduce in size or close with time).

The changes due to the hole might make her more prone to catching cold, so be careful. You need not panic. But remain prepared for a device closure later on.

Feel free to contact me back directly in case of any further queries.

Regards
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Diptanshu Das (23 hours later)
Dr,Her weight is now 15kgs and height 2feet and 6 inches,Can Device closure be done now?And what will be the approximately cost for the surgery?She does n't have any breathing or feeding difficulty,except sweating and viral infection frequently,otherwise very active and liveliness.
doctor
Answered by Dr. Diptanshu Das (2 minutes later)
Brief Answer:
Wait and observe.

Detailed Answer:
Thanks for writing back. I think that it would be a better idea to wait rather than getting it done right now.

There are a number of factors with which the cost may vary. The range can be wide, from about Rs.50,000 to Rs.3,00,000. However, the following links should be helpful for you:
http://www.wecareindia.com/heart-surgery/asd-closure-device-surgery.html
http://www.indianhealthguru.com/asd-heart-surgery-India-low-cost-benefits.html
http://www.wanlesshospital.org/cardiothe.htm
http://transmedglobal.com/get-a-quote-2/

The symptoms usually do not occur so early in life.

Regards

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

Pediatrician

Practicing since :2005

Answered : 3869 Questions

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Suggest treatment for ostium secundum in children

Brief Answer: The size is likely to stay constant. Detailed Answer: Thanks for asking on HealthcareMagic. I have gone very carefully through the details provided and have also checked the attachments. The hole size is likely to remain the same and even though there is difference in measured sizes, it just seems to be due to difference in measurements; I would not consider the size to vary. The hole in the heart is causing blood to flow from the left (from where the blood goes to the body) to the right (from where the blood goes to the lungs), thus leading to enlargement or dilatation of the right chambers while the blood overload on the lungs is leading to increase in the blood pressure in lungs (Pulmonary arterial hypertension or PAH). This would slowly be progressive and looking at the size, it does not appear to me that the hole will close on its own. But still the doctors wish to wait and watch (because certain holes do reduce in size or close with time). The changes due to the hole might make her more prone to catching cold, so be careful. You need not panic. But remain prepared for a device closure later on. Feel free to contact me back directly in case of any further queries. Regards