Comprehensive Clinical Management of Atrial Septal Defect: A Multidisciplinary Approach Bridging Nursing, Radiology, and Laboratory Sciences
Abstract
Background: Atrial Septal Defect (ASD) is a common congenital heart anomaly characterized by a persistent interatrial communication, leading to a left-to-right shunt. If left untreated, significant defects can cause right heart volume overload, pulmonary hypertension, atrial arrhythmias, and heart failure.
Aim: This article aims to provide a comprehensive overview of the clinical management of ASD, emphasizing a multidisciplinary approach that integrates insights from nursing, radiology, and laboratory sciences to optimize patient outcomes from diagnosis through long-term follow-up.
Methods: The review synthesizes current knowledge on ASD, covering its etiology, epidemiology, pathophysiology, and clinical presentation. It details the diagnostic evaluation, primarily via transthoracic and transesophageal echocardiography, with advanced cross-sectional imaging (CT/MRI) for complex cases. Management strategies, including conservative surveillance, percutaneous device closure for suitable secundum defects, and surgical repair for complex anatomies, are examined.
Results: Small ASDs may close spontaneously, but hemodynamically significant defects (Qp/Qs >1.5) require intervention to prevent complications. Percutaneous closure is effective for secundum defects with adequate rims, while surgical repair is necessary for primum, sinus venosus, and coronary sinus defects. Timely closure typically leads to reverse right heart remodeling and excellent long-term prognosis, whereas delayed treatment risks irreversible pulmonary vascular disease (Eisenmenger syndrome).
Conclusion: Effective ASD management relies on accurate anatomic and hemodynamic assessment to guide intervention. A coordinated, multidisciplinary team is essential for timely diagnosis, appropriate selection of closure method, and lifelong patient surveillance to prevent complications and ensure optimal quality of life.
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Authors
Copyright (c) 2025 Nouf Ibrahim Ahmad Alknani, Ali Humood Salah Alharbi, Ahlam Abdullah Hakami, Al Anoud Abdullah Al Qarni, Abdullah Khalif Alanazi, Alfaten Khalf Alshammri, Eman Kuliab Aldhafeery, Amnah Hassan Ahmed Asuni, Tuqa Musaad Alahmadi, Ibrahim Ahmed Khabrani, Abdullrahman Saad Rathaan Aldhafeeri, Jaiz Nahi Nawi Aldoferi, RAHMAH TANI SHARA AL DOSARI
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