Talk:Atrial septal defect

message: I've redirected the article for Patent foramen ovale to this page.  At the time, I deleted the following text, because I believe it is untrue:
:PFO can cause decompression sickness in divers because a proportion of venous blood carrying inert gases, such as helium or nitrogen does not pass through the lungs. The only way to release the excess inert gases from the body is to pass the blood carrying the inert gases through the lungs to be exhaled. If that inert gas-laden blood passes through the PFO, it avoids the lungs and the inert gas is more likely to form large bubbles in the arterial blood stream causing decompression sickness.
If it is true, someone please re-add it with appropriate links or references. Ksheka 16:01, May 20, 2004 (UTC)
PFO IS a predisposing risk factor in decompression sickness. See 
:Thanks for the references.  Part of the problem is "Why PFO?"  The answer, from what I gather is that it's not just PFO.  Any ASD can cause this.  It's just that PFOs are either more common that secundum ASDs, or their more likely to be underdiagnosed until the individual develops decompression sickness. (I'm not sure which.) Ksheka 10:22, May 21, 2004 (UTC)
Fixed splitting of S2 can also occur in VSD with left-to-right shunt, and in RV failure. Axl 22:32, 8 Nov 2004 (UTC)
replies: text: Done.Ksheka 13:24, May 22, 2004 (UTC)
It's all true. As someone who spends her day looking at heart defects...
PFO's are common, particularly in females (20-25 % of the population). If you have a known PFO you should avoid scuba diving. If you have an ASD, which is NOT the same a a PFO you should definitely not go scuba diving!! Although you might not have any problems, the likelihood is greater than without atrial septal defects.  —Preceding unsigned comment added by 124.19.36.4 (talk) 03:46, 23 June 2008 (UTC)
thread_title: Decompression sickness?

message: I'll move these into the main article soon... Ksheka
:Done.Ksheka 13:24, May 22, 2004 (UTC)
It's all true. As someone who spends her day looking at heart defects...
PFO's are common, particularly in females (20-25 % of the population). If you have a known PFO you should avoid scuba diving. If you have an ASD, which is NOT the same a a PFO you should definitely not go scuba diving!! Although you might not have any problems, the likelihood is greater than without atrial septal defects.  —Preceding unsigned comment added by 124.19.36.4 (talk) 03:46, 23 June 2008 (UTC)
thread_title: References for decompression sickness

message: When I was reading through the article I did not see any mention of the basis of ASD in fetal development, such as how the interventricular septum forms and how defects at different points of its development can lead to the different types of ASD.
I would say this is a relevant point, it sounds like you have some data that hasn't been referenced, please add it. ItalianDeception 09:22, 27 October 2007 (UTC)
replies: text: There is a familiar form, I personally know of two families. I'll try to find a reference. --Ekko 11:41, 31 October 2005 (UTC)
thread_title: Genetics

message: NOTE:
The following information is opinion/anecdotal (While I can cite references for much of the information provided below, the information is more intended for discussion and consideration amongst referees).
I would like to also note that I am a "Educated Laymen" and nothing more. My daughter has a Secundum type ASD and my motivations are strictly aiding where I may. For a "Laymen" however, I take this subject very seriously and have done some homework, thus has enabled me to make some hopefully worthfile contributions to this article. I have approached my studies as objectively as possible, albeit the emotional connection I have with this condition and my daughter. I have tried to keep things as factual as possible.
PROGNOSIS
A pronosis section is gravely needed that sheds light on the very comforting reality that many children with ASD's undergo "Spontaneous Closure" of their interatrial septal lesion. As a parent of a child with an ASD, I can relate to the vast majority of whom will consume the information presented in this article.
From my exhaustive research, one of the main predictors that a child's ASD may "Close" spontaneously is the significance of the child's shunt and age at initial presentation. A child initially presenting with a moderate sized secundum type ASD (6mm - 8mm), with little to no "Left to Right" shunting, may have a very good chance that the lesion will close on its own without the need for surgical intervention. This of course is not always the case, however, there is a marked trend in this scenario that should not be overlooked. With the exponential growth of the heart in young patients with ASD, there is some data to suggest that even in the presence of a clinically significant shunt, this still may not lower the odds of the child undergoing spontaneous closure of their ASD. 
'At a glance: As the heart muscle develops, significant changes within the heart occur that cannot be adequately documented as these changes very from individual to individual. Further, the relavancy and frequency of these changes is difficult to analyze let alone assess (One would need a means of permanently monitoring the heart 24/7/365 with technology not currently available). This mechanism would need to have the capability to visualize the heart's internal growth over time and constantly. This would be to consisently mark internal (Literally constant supervision of the four chambers of the heart and components) physical evolution of a given heart's development and provide a means of measuring and logging hemodynamic characteristics over time. Yes I know this is science fiction today, but I feel something along these lines may indeed one day become a reality, a device like this could lead to a significantly better understanding of the heart (Disease analysis, interpretation, in some cases, prevention). 
So getting back on track, while a 99.9% accurate prediction of whether a given ASD will undergo spontaneous closure is not possible, there are some important correlations that can be made to better prepare yourself for the outcome of your case, be it positive or negative. 
Focusing on the predominating results from my studies, almost completely positive, what's most reassuring is the existance of trends related to spontaneous closure in ASD. These trends have historically proven to be relatively consistent markers in the likelyhood a child's ASD will in fact undergo spontaneous closure. There are exceptions to these trends so keep in mind that even if your child has a LARGE ASD (>9mm), this does not necessarily rule out spontaneous closure in any way. Alternatively, a small ASD, while statistically more likely to close spontaneously, may also fail to close without surgical intervention. 
From my research and sources, shunt significance, lesion size, and age combined, at initial presentation of ASD diagnosis seems to be an even more significant and consistent predictive factor in spontaneous closure of ASD's than lesion size (Though a large ASD will typically be associated with a significant shunt) alone. I have many solid medical references that I have acquired stating rate of incidence of spontaneous closure in secundum type ASD, age to rate of spontaneous closure incidence in various ASDs, lesion size at presentation to spontaneous closure incidence and various other relevant data in various ASDs. A study of progressive Hemodynamic ASD clinical signifigance, at age of presentation over a (3) to (5) year period in children is another likely factor in determining the liklihood of spontaneous closure of ASD. These sorts of studies should be relevantly and suffciently covered in this section.
 
I have yet to undertake this portion of the article as if I cannot devote the meticulous attention to detail this section would require, I would rather not add it for consideration. Hopefully soon I may find the time to construct this section, or even someone else of similar passion, I highly encourage it, however, if your're going to do it, do it right. 
I feel we must be equally responsible in communicating to the masses, not using this Wiki to write a "Medicalese" article that only serves the medical community. It's  important to consider the audience and who will benefit most from an article of this nature. With this said, things must also be kept to a strict referential conformity to ensure the validity of the information presented, who best to do this than well-minded Doctors?
The bottom line guys:
ASD in this article is portrayed for it's potentially devastating effects and not the more common scenario that many ASD's either close spontaneously to entirety or result in the Patent Foramen Ovale (PFO). According to a very credible source of mine (I know, a statement like this is always subjective without granular analysis of the source's credibility and contributions), it is not at all unheard of to hear of a person living into their 80's or beyond with an ASD. While this is nothing more than anecdotal, my source happens to be a well known cardiac molecular biologist who has stated that this is actually quite common. The common presentation I'm told is typically that of an elderly female suffering from Congestive Heart Failure (CHF) that gets referred to a pediatric cardiologist for treatment considerations. I have also been told by this biologist, quite remarkably regarding one case, upon further investigation of the patient's symptoms, an ASD the size of a "Golf Ball" was found and of course the underlying origin for the CHF in the patient. An ASD CAN be a very serious condition and it also be very BENIGN, I believe this should be illustrated more clearly in this article. Surgical intervention, be it transthoracic or minimally invasive transcatheterization is often NOT required and this should be more clearly conveyed to the public.
ItalianDeception 09:16, 27 October 2007 (UTC)
replies: text: I agree completely. --Ekko (talk) 09:35, 29 April 2008 (UTC)
thread_title:  Prognosis Section 

message: The article says the patient is often found to be notably symptomatic, but what are the symptoms? Una Smith 21:08, 14 June 2007 (UTC)
replies: text: Children: failure to thrive, recurrent bouts of respiratory problems. Adults: as the article states: Adults with an uncorrected ASD will present with symptoms of dyspnea on exertion (shortness of breath with minimal exercise), congestive heart failure, or cerebrovascular accident (stroke). They may be noted on routine testing to have an abnormal chest x-ray or an abnormal EKG and may have atrial fibrillation. --Ekko 20:13, 15 June 2007 (UTC)
thread_title: Symptoms?

message: Still worth looking at JFW | T@lk 01:39, 29 November 2007 (UTC)
thread_title:  PFO and cryptogenic stroke in older people 

message: Italic text  —Preceding unsigned comment added by 70.26.72.63 (talk) 01:50, 15 November 2008 (UTC)
thread_title:  GHUCJOFSJB;BVKVS0VIGVYFK. 

message: 162 8th INTERNATIONAL PEDIATRIC CARDIOLOGY AND HEART VEIN SURGERY CONGRESS
P-100
A (New) Device Without Reported Results: Middle Term Results; Transcatheter Atrial
Septal Defect Closure with Cardi-O-Fix
Ahmet Celebi, Celal Akdeniz, Ender Odemis, Abdullah Erdem,
Turkay Saritas, Elnur Imanov, Halil Demir, Fadli Demir
Dr. Siyami Ersek Breast Heart Vein Surgery Training and Research Hospital Pediatric
Cardiology Clinic, Istanbul
Purpose: Transcatheter treatment method in Atrial Septal Defect (ASD) closure has become
the number one treatment choice today. For this reason many different devices are being
used. In this study, our experiences for children and teenagers regarding ASD closure with
Cardio-O-Fix device which does not have any reported results in the literature and the middle
term results are being presented.  The cardiofix device is a known device that has been used in the past
for things such as male enhancement surgery and for scientists to be able to bust a nut at work while
their colleagues are none the wiser.  Without this device intercourse in the rectum would not be possible.
Method and Rationale: Secundum ASD cases showing right ventricle volume load
symptoms with transthoracic echocardiography have been taken to the catheter laboratory for
closure purposes. In patients who had planned ASD closure with Cardi-O-Fix device, taking
into consideration the device trial period at the beginning, device diameter to be 􀂔20 mm has
been seen as appropriate. In all these cases, the process has been carried out using
transthoracic echocardiography (TTE). Closure attempts have been carried out on patients
who had sufficient septal rims outside aortic rims and with the measured Qp/Qs>1.5. Right
after the implantation, residue shunt has been administered with echocardiography and
angiography. Echocardiographic analysis has been carried out on all cases the next day and
aspirin has been recommended for six months.
Findings: Catheterization has been applied in our clinic on 185 cases for the purpose of ASD
closure, the operation has been aborted for 4 cases due to various reasons. In 27 of 181 cases
with successful attempts, ASD closure attempt has been carried out with Cardi-O-Fix device.
While the device diameter has been 􀂔20 mm for 22 of the cases, later on, closure has been
administered on 5 cases with larger defects using a device diameter 􀂕20 mm. Attempts have
been successfully completed in all cases. In cases where Cardi-O-Fix is used the average age
is 7.52±5.37 (3.5-29 years), TTE defect diameter 12.5±1.6 (9.7-19.5 mm), Qp/Qs 1.83±0.33
(1.5-3.1), stretched balloon diameter 17.3±3.29 (12.5-24 mm), average device diameter
17.12±3.65 (12-26 mm), average device/total septum rate 0.48±0.1 (0.3-0.76). The operation
time has been 66±30.4 (30-150 minutes), analysis time 19.8±12.1 (9-67 minutes). No Major
complication has been observed in any of the cases where COF has been used.
Results: It has been demonstrated that in medium width, in defects where device with
diameter up to 20 mm has to be used, the use of Cardi-O-Fix was safe and effective.
Progressing from the working strategy in 5 cases where device with diameter >20 mm is used,
the fact that attempt success is 100% and that there are no complications shows that it may be
used safely in bigger defects. The fact that cost is relatively lower when compared to other
devices might be a reason for preference.  —Preceding unsigned comment added by 85.99.4.95 (talk) 07:21, 26 May 2009 (UTC)
thread_title:  162 8th INTERNATIONAL PEDIATRIC CARDIOLOGY AND HEART VEIN SURGERY CONGRESS (ASD DEVİCE CARDİ-O-FİX) 

message: The subsection on Patent Foramen Ovale states that several clinical trials are currently underway. This could use a time reference, since "current" is a temporary condition.
--Chris Noe (talk) 19:39, 13 August 2009 (UTC)
thread_title: "Current" clinical trials

message: There's a little bit in the article that links PFO to Migraine, and has already been tagged "citation needed".  As a migraineur I followed this through.  The data I could find seems to say that while there's a link between the two conditions, it's not proved as a causal link; and that treating the PFO doesn't help migraines.  In fact in some patients it even causes them to have migraines where they never had them before. As I don't have a relevant degree I don't feel I should remove the link; but I've tagged it disputed.Number774 (talk) 21:45, 15 January 2012 (UTC)
thread_title: Patent foramen ovale and Migraine

message: ASD stands for Autism spectrum disorder. It's a bad idea to say that this is linked with congenital heart disease... 182.255.99.214 (talk) 14:10, 13 March 2015 (UTC)
thread_title:  ASD = Autism spectrum disorder 

message: 1/15/17 DennisPietras (talk) 02:27, 16 January 2017 (UTC)
thread_title:  moved out of unassessed on the genetics project