Cardiothoracic Surgery

A.S.D. Patching

With the continuous development of modern medicine, the treatment technology for ASD of atrial septal defect has been very mature. Basically passed the surgical treatment, the atrial septal defect can be cured. However, changes in cardiac fitness may not return to their original state. But it does not affect daily life, and it can be the same as normal people. The best treatment time: general surgery is recommended to be treated after the initial diagnosis of the disease, special surgery should be prescribed. Treatment of diseases: atrial septal defect in children with atrial septal defect Indication Room septal defect repair surgery for a variety of atrial septal defect, success rate of nearly 100%, also applies to other congenital heart disease, coronary heart disease, aortic dissection and heart valve disease. Contraindications (1) I-type ASD and coronary sinus ASD; (2) diameter 4 or 35mm, the edge of the defect to the coronary sinus, the distance between the superior and inferior vena cava 5mm; (3) endocarditis and hemorrhagic patients; (4) accompanied by partial or complete pulmonary venous drainage; (5) Inferior vena cava, pelvic vein thrombosis leads to complete obstruction or venous thrombosis at the catheter insertion, thrombus in the place of occluder, thrombus formation in the heart cavity; (6) Severe pulmonary hypertension with right to left shunt; (7) ASD combined with other cardiac malformations requiring surgery; (8) with severe myocardial disease, valvular disease, congenital defect or large vessel abnormality unrelated to ASD; (9) The marginal condition of the atrial septal defect is insufficient to firmly place the occluder; (10) poor development of the left atrium and left atrium; (11) Repeated pulmonary infection, severe infection occurred within 1 month before sepsis or occlusion. In addition, those younger than 1 year old are relatively contraindicated. Preoperative preparation Antibiotics are routinely used before surgery. Surgical procedure 1. Percutaneous puncture of the femoral vein, insertion of a vascular sheath to establish a vascular path. 2, right heart catheterization 3, measuring the diameter of the atrial septal defect 4, sealing atrial septal defect 5, withdraw the conveyor and the delivery sheath, partial compression and hemostasis after pressure dressing. complication (1) coronary embolism, cerebral embolism, cerebral hemorrhage: should be oxygen, the corresponding drug treatment. (2) femoral arteriovenous fistula: local compression, if invalid, the diameter of the fistula 3mm can be followed up, generally self-healing; can not be self-healing during follow-up and the diameter of the fistula > 3mm can be placed with a stent Repair or surgery. (3) The occluder is detached: the surgical procedure is performed if the foreign body clamp is unsuccessful. (4) cardiac tamponade: pericardial puncture drainage, if necessary surgery. (5) Aorta - right atrium or left atrium: surgery. (6) Arrhythmia: Drug treatment as appropriate. (7) atrioventricular valve perforation regurgitation: light can be followed up for observation, severe surgical treatment. (8) Allergic to occluder: light can be treated with drugs; severe cases should be surgically removed occluder. (9) Headache: Strengthen anticoagulant and symptomatic treatment of drugs.

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