It is the defect in inter-atrial septum that is situated between 2 upper chambers of heart (right and left atriums). It is usually there in newborns in the form of PFO and PFO is essential for fetal survival. Majority of PFO’s close in some time.

Varieties of ASD 
1. Ostium Secundum (OS-ASD)
2. Ostium Primum
3. Sinus venosus (SVC and IVC types) defect
4. Coronary sinus type defect

Ostium secundum atrial septal defect is the most common type.
This type of ASD is suitable for closure by non-surgical means that is by using a device angiographically.

Other types of ASDs are treated by surgical method.

Clinical presentation of ASD? 
Majority are asymptomatic. Others may be having poor weight gain, easy fatigue.

As majority is asymptomatic, ASD can be easily undiagnosed in early childhood. Some patients are coming in late adulthood for closure of ASDs.
If we are examining the child carefully then we can at least raise the doubt of ASD, but for confirming it, echocardiography needs to be done.

Management of Atrial Septal Defect
ASD can be treated either by surgery or by non-surgery (by using an umbrella device in cath lab).

ASD surgery can be done either from mid sternum or by latest technique of “minimal invasive cardiac surgery (MICS)”.

Advantage of MICS surgery is that it will not produce major scar over the chest.
Types of ASD that is closed by surgery is Primum defect, sinus venosus defect, coronary sinus ASD, latge OS-ASD with poor margins/rims.

ASD that can closed by without surgery is OS-ASD with good rims all around keeping weight of child into consideration. (ASD device closure in cath lab).

Kindly refer to “Intervention section” of for detailed discussion of ASD device closure.

Ostium Secundum ASD in Transesophageal echocardiography

Post ASD device closure on Transesophageal Echocardiography

Ostium Secundum ASD in transthoracic echocardiography

Sinus Venosus Defect: SVC Type in 4 chamber view

Sinus Venosus Defect: SVC Type in subcostal view