Conversation: The conversation between human and AI assistant.
[|Human|] Dear Doctor, I am 45 year female  from Lucknow need advise through your section as a cardiologist told me that my herat is inoperable condition. I am suffering from Cardiac problem since last 20 years like pain in chest, dizziness, swelling in feet, breathing problem etc. then i visited a cardiologist and he performed echocardiogram, the results are following -1. Large Ostium, Secundum ASD with severe PAH (ASD Defect 25mm)2. Mindely Dilated RA & RV3. Good LV, Systolic function4. LVEF =77%5. Trival MR6. Mild TR7. Mild PR8. Normal Pulmonary connection9. No clot/vegetationTherefore I want to know that is there surgery is possible in this case or not.Please advise me.  Best Regards,suman
[|AI|]  Hello In patients with ASD with the passage of time the shunt become reversed (right to left) due to increased pulmonary vascular resistance. These patients develop severe PAH due to which It's become impossible to close the defect. It's Called Eisenmengerisation of the shunt. This could be the possible reason in your case keeping in mind SEVERE PAH reported in your ECHO report. See in the report if its written Reversal of shunt or right to left shunt across ASD then surgery is not possible Take Care