Got atrial septal defect, these two kinds of operation way, treatment can not be careless

Thank you, Professor Zeng! Two hospitals do not dare to do the operation, you do it for me. I don’t have to wait to die! ” A patient who came back for the first time after he was discharged from the hospital, before he sat down in the consulting room, came here with such a sweet word. < / P > < p > two weeks ago, also at this specialist clinic, she told her “story”: in her 40s, she had two children. There are atrial septal defect, bronchiectasis, asthma. 3、 Four years ago, because of atrial septal defect, shortness of breath gradually appeared. Two times, they were hospitalized in the cardiac surgery department of two leading hospitals in Guangdong Province. Both times, they were unable to undergo surgery because of severe bronchiectasis and asthma. In one case, the anesthesiologist refused anesthesia after being pushed into the operating room; in another case, the doctor in charge was willing to perform the operation, while all other doctors in the Department objected, and lost the opportunity of operation. < / P > < p > in recent years, the disease has worsened and the ability of physical labor has disappeared. Two weeks ago, I hope I can help her with the operation. After carefully looking at the heart ultrasound, it’s really atrial septal defect. And if we don’t plug the gap, it’s really like what she said, “there’s no chance of surgery, we have to wait to die.”. The pulmonary artery pressure was 44 mmHg last year and 53 mmHg this year. If it rises again, the pressure of right atrium is higher than that of left atrium, and the blood flow is shunted from right atrium to left atrium, then the chance of operation will be lost forever and the patient will die soon. < / P > < p > I decided to help her with transcatheter closure of atrial septal defect without anesthesia. Of course, she was admitted because of bronchiectasis, infection and asthma. Both lungs are in poor condition, with mild respiratory failure. < / P > < p > after a few days of treatment, when the lung condition slightly improved, we punctured the blood vessel through the femoral vein and sent the atrial septal occluder to the defect site, and successfully completed the occlusion operation in less than an hour. Two days after operation, echocardiography showed that the gap was completely closed, the pulmonary artery pressure was 35mmhg, which was 16mmhg lower than that before operation, and the normal value was less than 30mmhg. < / P > < p > in outpatient follow-up, it was found that the lung condition was significantly better than that before operation. I predict that after transcatheter closure of atrial septal defect, the pulmonary artery pressure will further decrease because it can reduce the abnormal invalid blood flow in the lung and create good conditions for reducing repeated pulmonary infection. < / P > < p > as for atrial septal defect (ASD) and ventricular septal defect (VSD) in congenital heart disease, the blood from the left heart was initially shunted to the right heart through the gap. With the passage of time, shunt increased pulmonary blood flow and pulmonary artery pressure, and the patient began to shortness of breath, even accompanied with right heart failure such as foot swelling and anorexia. < / P > < p > if the condition further develops and the pulmonary artery pressure further increases, when the right heart pressure is higher than the left heart pressure, part of the blood will be shunted to the left heart through the gap without oxygen exchange in the lung, and then the blood with low oxygen content will circulate to the whole body. At this time, the patient’s lips will change from red to purple. At this time, the gap closure has become an absolute contraindication of surgery, and life is coming to an end. < / P > < p > atrial septal defect, ventricular septal defect, patent ductus arteriosus have two kinds of surgical methods: traditional cardiac surgery thoracotomy, cardiology interventional occlusion. Cardiac surgery can be performed in all abnormal sites; interventional surgery in cardiology has requirements for the surrounding anatomical structure of abnormal sites. Focus