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4 yo old, ostium secundum atrial septal defect, ASD device

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My son is 4 years old, diagnosed now with ostium secundum atrial septal defect of 20 mm. Advised correction with device closure. What are the risks and complications of device closure? By what maximum age the defect should be corrected? Any diet and activity restrictions for the child? Is the defect has any ill effect of child's overall development? What is the prognosis after the ASD device closure procedure?

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replied May 31st, 2015
Kids Health and Pediatrics Answer A52442
Welcome to e health forum.

The ostium secundum defects make up approximately about 90% of all atrial septal defects.

A defect larger than 9mm is considered to be large. Most kids with such defects grow up like normal kids but become symptomatic in adult age. More than 70 percent develop symptoms by about 40 years of age and develop symptoms due to pulmonary hypertension, enlargement of the right side of the heart and ultimately heart failure.

Not all children with an atrial septal defect are candidates for surgery. Surgery is only indicated for those children with clinically significant left-to-right shunting.

Surgery is ideally performed in children aged 2-4 years and has a very low mortality rate. However, surgery may be performed earlier than this if the child has evidence of CHF. Surgery can be deferred until later in childhood if there is a specific family preference without adding any substantial risk by delaying intervention.

Since the defect in your son is very large (20mm) it is likely that he already has symptoms or might develop symptoms sooner. Hence your doctors might have recommended early treatment with Transcatheter placement of a inter-atrial device. The device plugs the hole in the atria and within 6 months, normal tissue grows in and over the device. There is no need to replace the closure device throughout the patient's life.

The overall prognosis after the procedure is excellent.

I hope the information here is helpful.

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