Pediatric Heart Expert Forum
ASD Closure?
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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ASD Closure?

Dear Doctor, My 27 month old daughter had total repair of ToF, using a Trans Annular Patch, at six-months- of-age.  She now has a 4 to 6mm ASD with left to right shunting and mild pulmonary regurgitation.  Her last report included the following....S1 is normal and there is a single S2.  There is no S3, S4, or click.  There is a 2/6 soft ejection murmur at the upper left sternal border radiating faintly to the back follwed by a 1/6 diastolic murmur of pulmonary regurgitation.  
       In your opinion should she have the ASD closed via a Transcatheter Occluder soon or wait til if/when she needs the Pulmonary Valve replaced?
       Thank you, Joe
                        
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There is no reason to close this relatively small ASD at this time. There is still some time for it to get a bit smaller on its own.  If the right sided heart chambers grow significantly as she gets older, then it might be worthwhile to consider, but not necessarily at this young age.  the only reason to intervene now would be if the right sided heart chambers were severly dilated or the right ventricle was not pumping well.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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Marie M Gleason, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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