Medical and Surgical Care of Ostium Secundum Atrial Septal Defects
Newborns with small foramen secundum atrial septal defects have been shown to spontaneously correct by the third or fourth year of life. Therefore, medical supervision is generally accepted as a preventative measure for those diagnosed in infancy rather than surgical intervention or use of other medical devices.
If surgery is required, it is performed using minimally invasive techniques via robotic surgery that often requires only two to three days of inpatient hospital stay. Surgical intervention should result in full closure of the foramen secundum and mortality rates are similar to those for general anesthesia. The repair can be made by suturing the atrial septum or, if the foramen secundum is large in size, a patch can be made from the patient's pericardium to fully separate each atria. The synthetic material Dacron is also used to create a repair patch.
The insertion of a catheter has proven to be a safe and highly successful method for closing the foramen secundum in children. This method prevents the symptoms that are expected to accompany most ostium secundum atrial septal defects. The catheter is inserted into the femoral vein in the leg and moved into place in the atrial septum. Transesophageal echocardiography is accepted as the method to monitor this procedure which, when performed correctly, has shorter recovery times than surgical intervention. Complications of catheter insertion often include nausea and vomiting, blood vessel obstruction, pain, and hemorrhage. The most common problem with this preventative measure is the incomplete closing of the foramen secundum. There are currently no drug therapies for ostium secundum atrial septal defects, although infective endocarditis is a postoperative concern. To prevent this condition, a prophylactic is used for six months after the operation.
Read more about this topic: Foramen Secundum
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