Document Detail

Contemporary clinical management of atrial septal defects in the adult.
MedLine Citation:
PMID:  18035929     Owner:  NLM     Status:  MEDLINE    
Patients with simple congenital heart disease, such as isolated atrial septal defects (ASDs), are rapidly becoming a relatively large population with a variety of clinical problems that are often missed by pediatric physicians or grown-up congenital heart disease specialists and may involve different adult health professionals, such as general cardiologists or internists. A Medline search was performed to search for randomized trials, prospective cohort studies, meta-analysis, reviews and practice guidelines regarding different aspects of ASD in adults over a 6 year period. Isolated ASD are common (7% of all cardiac anomalies) and can present at any age, sometimes in conjunction with other genetic disorders such as Down syndrome or in a familiar form. The diagnosis is often accidental: Doppler echocardiography and, more recently, MRI are mandatory to assess types and significance of ASDs. Surgical or percutaneous repair should be offered at any age unless associated with pulmonary vascular disease: percutaneous closure should be preferred in isolated secundum ASD with sufficient rims on transesophageal echocardiography, whereas surgery remains the only option for primum and sinus defects. Follow-up of operated patients is based on Holter ECG and echocardiography, which should be scheduled every 2 years for secundum and sinus defects and every year for primum defect with valve repair. ASDs in adolescents and adults may be suspected in any physician's office and doctors should be acquainted with innovative imaging techniques and contemporary therapeutic options in order to deliver proper care to different types of ASDs and assist them after repair with appropriate follow-up strategies.
Gianluca Rigatelli; Paolo Cardaioli; Ziyad M Hijazi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert review of cardiovascular therapy     Volume:  5     ISSN:  1744-8344     ISO Abbreviation:  Expert Rev Cardiovasc Ther     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-26     Completed Date:  2008-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101182328     Medline TA:  Expert Rev Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1135-46     Citation Subset:  IM    
Rovigo General Hospital, Section of Congenital and Structural Heart Disease Interventions, Viale Tre Martiri, 45100 Rovigo, Italy.
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MeSH Terms
Balloon Occlusion / methods*
Cardiac Surgical Procedures / methods
Echocardiography, Doppler
Echocardiography, Transesophageal
Heart Catheterization
Heart Septal Defects, Atrial / diagnosis*,  therapy*
Risk Assessment
Severity of Illness Index
Surgical Procedures, Minimally Invasive / methods
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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