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Atrial Septal Defects (ASD)

The presence of a defect (opening) in the septum that separates the two atria of the heart. It can be congenital or acquired.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Atrial Septal Defects (ASD)

An atrial septal defect (ASD) is a hole in the part of the septum that separates the atria. (The atria are the upper chambers of the heart.)

An ASD allows oxygen-rich blood to flow from the left atrium into the right atrium, instead of flowing into the left ventricle as it should. So, instead of going to the body, the oxygen-rich blood is pumped back to the lungs, where it has just been.

An ASD can be small, medium, or large. Small ASDs allow only a little blood to flow from one atrium to the other. Small ASDs don't affect how the heart works and don't need any special treatment. Many small ASDs close on their own as the heart grows during childhood.

Medium and large ASDs allow more blood to leak from one atrium to the other. They're less likely to close on their own... Read more about Atrial Septal Defects NIH - National Heart, Lung, and Blood Institute

What works? Research summarized

Evidence reviews

Amplatzer transcatheter and surgical closure for ostium secundum atrial septal defects: a systematic review

Bibliographic details: Tang C, Zeng Z, Li J, Cao W Z, Huang P.  Amplatzer transcatheter and surgical closure for ostium secundum atrial septal defects: a systematic review. Chinese Journal of Evidence-Based Medicine 2007; 7(4): 267-275

Atrial septal defect closure is associated with a reduced prevalence of atrial tachyarrhythmia in the short to medium term: a systematic review and meta-analysis

Atrial tachyarrhythmias are a common complication of atrial septal defects. The objective was to determine the effect of atrial septal defect closure on pre-existing atrial tachyarrhythmias and to investigate if such an effect is present after either surgical or percutaneous closure. Medline, EMBASE, Cochrane Library, and Google Scholar databases were searched between 1967 and 2009. The search was expanded using the 'related articles' function and reference lists of key studies. All studies reporting pre- and post- closure incidence (or prevalence) of atrial tachyarrhythmias in the same patient groups were included. Data were independently extracted by two authors according to a pre-defined protocol. Incongruities were settled by consensus decision. Twenty six studies were identified including 1841 patients who underwent surgical closure and 945 who underwent percutaneous closure. Meta-analysis using a random effects model demonstrated a reduction in the prevalence of atrial tachyarrhythmias following atrial septal defect closure [OR = 0.66 (95% CI 0.57-0.77)]. This effect was demonstrated after both percutaneous [OR = 0.49 (95% CI 0.32-0.76)] and surgical closure [OR = 0.72 (95% CI 0.60-0.87)]. Immediate (<30 days) and mid-term (30 days - 5 years) follow-up also demonstrated a reduction in AT prevalence [ORs of 0.80 (95% CI 0.66-0.97) and 0.47 (95% CI 0.36-0.62) respectively]. Atrial septal defect closure, whether surgical or percutaneous, is associated with a reduction in the post-closure prevalence of pre-existing atrial tachyarrhythmias and atrial fibrillation in the short to medium term.

Newborn screening for congenital heart defects: a systematic review and cost-effectiveness analysis

The objectives of this study were to provide evidence to inform policy decisions about the most appropriate newborn screening strategy for congenital heart defects and to identify priorities for future research that might reduce important uncertainties in the evidence base for such decisions.

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Summaries for consumers

Omega‐3 fatty acids for autism spectrum disorders (ASD)

It has been suggested that difficulties associated with ASD may be explained in part by lack of omega‐3 fatty acids, and that supplementation of these essential fatty acids may lead to improvement of symptoms. The purpose of this review was to assess the evidence for the effectiveness of omega‐3 supplementation for core features of ASD and associated symptoms. We found only two small randomised controlled trials that evaluated omega‐3 fatty acids for ASD. There is insufficient evidence that omega‐3 fatty acids supplementation is an effective treatment for ASD. However, high quality large randomised controlled trials are needed before definite recommendations about this treatment can be made.

Intravenous secretin for autism spectrum disorders (ASD)

Secretin is a gastrointestinal hormone that was first presented as an effective treatment for ASD in 1998, based on anecdotal evidence. On the basis of these first reports many families sought treatment with intravenous secretin for their children with ASD even though secrein was not a proven, effective treatment and there was inadequate information about side effects when used in this group of children. This review included 16 randomised trials with a placebo control group, with over 900 children involved. The review found no evidence that single or multiple dose intravenous secretin is effective in improving the main problems seen in ASD, namely a lack of social interaction and communication and restrictive, repetitive behaviours and routines. As such, currently it should not be recommended or administered as a treatment for ASD. Further experimental assessment of secretin's effectiveness for ASD can only be justified if there is convincing new evidence that finds that secretin can influence brain function in a way that could benefit children with ASD or a link is proven between secretin and the known cause of ASD for some or all children.

Social skills groups for people aged 6 to 21 years with autism spectrum disorders (ASD)

Social deficits remain one of the most difficult areas for individuals with autism spectrum disorders, especially for those with average or above average cognitive skills. An intervention often used to treat social deficits for these individuals is social skills groups. This review synthesized the results of five randomized controlled trials of social skills groups including 196 individuals with autism spectrum disorders (aged 6 to 21 years). We found individuals receiving treatment showed some indications of improved social competence and better friendships when compared with those not receiving treatment. Participants receiving treatment also showed indications of less loneliness. The ability to recognize different emotions was measured in two studies and there was no evidence that it was improved by taking part in a social skills group. Social communication as it relates to idiomatic expressions was only reported in one study and no significant differences between treatment and control group were found. Nor was there evidence of a beneficial effect of social skills groups on parental or child depression. No adverse effects were reported in the studies. Limitations of this review include a small number of studies and participants, and a high risk of bias due to parents knowing whether their child was in the intervention group or not. The studies focused mainly on children with ASD aged 7 to 12 with average or above average intelligence, and they were all carried out in the US.

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Terms to know

Atria
The chambers of the heart, to which the blood returns from the circulation.
Congenital Heart Defects (Congenital Heart Diseases)
Congenital heart defects are problems with the heart's structure that are present at birth.
Heart
The hollow, muscular organ that maintains the circulation of the blood.
Heart Ventricles
The lower right and left chambers of the heart.
Interatrial Septum
The tissue that separates the right atrium from the left atrium in the heart.
Lungs
One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

More about Atrial Septal Defects

Photo of a baby

Also called: Interatrial septal defects

Other terms to know: See all 6
Atria, Congenital Heart Defects (Congenital Heart Diseases), Heart

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