Patients with atrial septal defects -- a hole in the top chamber of the heart -- should have reparative surgery without delay rather than wait for symptoms to appear at a later age, according to researchers at the University of Toronto Congenital Cardiac Centre for Adults.
In a paper to be published in the March 18 edition of the New England Journal of Medicine, researchers have put an end to the ongoing debate about when to treat congenital atrial septal defects (ASD) that cause the right chamber of the heart to enlarge.
"Scientists have long said reparative surgery was unnecessary until the patient started showing symptoms, usually at a later age," says lead author Dr. Michael Gatzoulis, a senior fellow in U of T's department of medicine and a staff cardiologist at the Toronto Hospital (TTH). "We have shown this is wrong, and that surgery earlier in life will actually prevent future symptoms."
Because patients often live symptom-free until middle-age, these defects are often only found by chance, during an electrocardiogram or other examination. "In a previous era, we were only able to pick up these defects at a more advanced stage of the disease," says senior author Dr. Louise Harris, assistant professor in U of T's department of medicine and a staff cardiologist at TTH. "Now we're able to detect them earlier and restore normal blood circulation by closing the hole early enough to hopefully prevent arrhythmia."
One in one hundred Canadians is born with some form of congenital heart disease,
with atrial septal defects being the most common form. ASD patients are born
with a hole in the wall between the top collecting chambers of the heart which
causes the blood to shunt, or flow, from the left to the right chamber. The
right side of the heart eventually enlarges as it must work harder to keep the
extra blood flowing, leaving the patient with an irregular heart beat or
palpitations. Other symptoms include fatigue, lung damage, heart failure a
Contact: Steven de Sousa
University of Toronto