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DEVICE CLOSURE OF SEPTAL DEFECTS

A Simple Explanation

This treatment involves using of Closure Devices or implants to treat patients with septal defects.

Septal Defects

Septum or Septa is a wall that divides a cavity into smaller ones. The heart is divided into four chambers, two upper chambers (atria) and two lower chambers (ventricles), by septa. The walls or septa of the heart might have defects that can seriously damage the functioning of the heart. The main two types of Septal Defects are:

Atrial Septal Defect (ASD)

This is a congenital heart defect in which blood flows between the atria (upper chambers) of the heart.

The Interatrial Septum that separates the Atria, is defective or absent, then oxygen-rich blood can flow directly from the left side of the heart to mix with the oxygen-poor blood in the right side of the heart, or vice versa. This causes lower-than-normal oxygen levels in the arterial blood that supplies the brain, organs, and tissues.

If the ASD is large, the extra blood volume floods the lungs and overwork the heart. If this defect is untreated, the right side of the heart enlarges and weakens and can lead to Pulmonary Hypertension, i.e., high Blood pressure in the lungs. However, a smaller ASD may not produce noticeable signs or symptoms.

Risk Factors

Congenital heart defects usually run in the family and sometimes appear with other genetic problems, like Downs Syndrome.

The mother having any of the conditions during pregnancy, risks the baby to have heart defects.

  • Rubella Infection(German Measles): getting infected in the first few months of pregnancy.
  • Consumption and exposure to drugs, alcohol or tobacco can harm the foetus.
  • Diabetes or Lupus
  • Obesity
  • Phenylketonuria (PKU): if the mother has PKU and doesn’t follow the PKU meal plan increases the risk.

Ventricular Septal Defect (VSD)

This is a defect in the ventricular septum, the wall dividing the left and right ventricles (lower chambers) of the heart. The extent of the opening may vary from pin size to complete absence of the ventricular septum, creating one common ventricle.

The ventricular septum consists of an inferior muscular and superior membranous portion and is extensively innervated with conducting cardiomyocytes (cardiac muscle cells).

The more common type of VSD is one where the membranous portion, which is close to the atrioventricular node, is affected.

Risk Factors

Congenital VSDs are associated with other congenital conditions like Down’s syndrome. The incomplete looping of the heart during the 24-28 days of the development is a cause of congenital VSD.

A Myocardia Infraction (heart attack) can also result in a VSD due to the mechanical tearing of the septal wall, before the forming of the scar tissue.

The Procedure

Common Part of the Procedure

The procedure for ASD and VSD are usually performed in the cardiac catheterization lab, using catheters (thin, flexible tubes).

Usually, the catheter will be inserted via a blood vessel in the groin and navigated until it reaches the heart using fluoroscopy.

The procedure differs slightly for treating each case.

ASD

The catheter is positioned at different heart’s chambers to measure the pressure and oxygen content prior to device closure. Sometimes, balloon sizing of the ASD may be required. The appropriate size device is connected onto a cable, put into a special delivery tube, advanced through the ASD and carefully deployed.

VSD

The Amplatzer muscular VSD occluder may be used to close certain VSDs. It is shown to have full closure of the VDS within the 24 hours of placement. It has a low risk of embolism after implantation.

Some tricuspid valve regurgitation was shown after the procedure that could possibly be due from the right ventricular disc.

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Billroth Hospitals,
43, Lakshmi Talkies Road, Shenoy Nagar,
Chennai-30.

+91-44-42921777

+91-7299404040

admin@billrothhospitals.com

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