Transcatheter Closure of Atrial Septal Defects

Abstract
The term congenital heart disease encompasses a vast array of lesions that present unique anesthetic challenges. Making up close to 10% of all congenital heart disease, atrial septal defects are some of the more commonly encountered congenital lesions. Atrial chambers in the heart are separated by a septum that forms during embryological development. When the septum does not develop normally, blood communicates between the right and left atria. This alteration in flow has significant effects on both cardiac and pulmonary anatomy and physiology. Cardiothoracic surgery used to be the only way to close defects that did not spontaneously close. Transcatheeter device closure of atrial septal defects in the cardiac catheterization lab has become increasingly common and offers significant advantages over open heart surgery. This chapter highlights the anatomic and physiologic considerations of the different types of atrial septal defects and discusses the details of transcatheter closure including indications, timing, and risks.

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