Normally, the foramen secundum closes after the baby is born. After the baby is born, the pressure in the left atrium is greater than that in the right atrium, so just press the patch onto the hole to erase the hole.
The fear is that for some people, the defect is too big and the patch is not big enough to cover it up or close it completely. Such people account for a certain proportion of the population, and it is not low, perhaps as much as 20 to 30 percent. Another major type of atrial septal defect occurs here, called secundum atrial septal defect.
Hearing this, some people couldn't believe that so many people were suffering from this disease because they rarely heard of such patients around.
This is because the pores in most of these people are very small, which basically does not affect the cardiac hemodynamics. The patients are asymptomatic and do not seek medical treatment or have the defect discovered. Even if it is discovered, it does not affect human health. Medically, it is believed that no intervention is necessary. Why get stabbed if there's nothing wrong?
People who need surgery are those who have symptoms. This symptom is based on the large area of the defect. Too much blood is pumped from the left atrium into the right atrium, causing pulmonary hypertension. Persistent pulmonary hypertension will evolve into organic lesions of the pulmonary arteries, causing the blood in the right atrium to be pumped back into the left atrium and left ventricle, resulting in manifestations of left heart failure and cyanosis. This type of evolution is called Eisenmenger syndrome. At this point, we know from previous cases that it is very troublesome and the only option is lung transplantation.
If surgery is required, it must be done early so that the problem can be discovered and resolved promptly. The problem is that this type of disease can only be detected by electrocardiogram or chest X-ray when pulmonary hypertension or arrhythmia occurs.
Even if the defect area is large, these patients will at most show symptoms of being susceptible to colds during childhood, with no other obvious symptoms, and the disease cannot be detected through routine physical examinations.
When people reach adolescence, some symptoms appear, such as shortness of breath more easily than normal people.
We Chinese like to classify this type of patients as those with weak constitutions, and never consider that they may have organic diseases. The main reason is that the inspection items are too simple and inappropriate to carry out necessary screening.
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These patients can continue to live as long as they do not develop severe pulmonary hypertension. The symptoms become more and more severe after the age of 40, and by then the disease is finally detected and you will know that you need to do a cardiac ultrasound. If you miss the opportunity for surgery for pulmonary arterial hypertension, your life expectancy will be shortened by 10 to 20 years.
For treatment, there is the option of interventional occlusion after interventional surgery. Like other interventional surgeries, interventional surgeries have conditions and thresholds. If the defect is in a bad location or has a strange and complex shape, interventional surgery cannot be performed and the only option is surgery.
The male-female incidence rate of this disease is more than twice that of males.
The girl in bed 12 was examined upon admission and showed echo loss in the central part of the atrial septum, which was about 30 mm in size. Color flow analysis showed left-right shunt at the atrial level. The defect is large and the edges are uneven, so intervention is not possible and the patient is referred to surgery.
Most of the heart surgeries were done through the two median sternotomies performed previously. Today I heard the teachers discussing in a low voice that they might make an external chest incision under the right armpit of the chest.
In the early days of open heart surgery, episiotomy was actually performed. Later, it was discovered that cutting the sternum to expose the surgical field was very convenient for doctors to operate. Some very complicated heart diseases could only be performed by cutting the sternum.
In modern times, the right-side incision has returned to the field of cardiac surgery. This is because doctors have found that there is no problem in continuing to use the right-side incision for less complicated heart diseases. In addition, the surgical scar left by the incision in the armpit is easy to hide and can be covered by the drooping arm, which meets the patient's pursuit of beauty.
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