房间隔缺损(ASD)

房间隔缺损图

What is it?

An opening or hole (defect) in the wall (septum) that separates the top two chambers of the heart (atria).

This defect allows oxygen-rich blood to leak into the oxygen-poor blood chambers in the heart. ASD是心脏两个上腔之间的隔膜缺陷. 隔膜是分隔心脏左右两侧的一堵墙.

给自闭症儿童家长的更多信息

原因是什么??

每个孩子出生时，上心室之间都有一个开口. 这是一个正常的胎儿开口，让血液在出生前绕过肺部. After birth, the opening is no longer needed and usually closes or becomes very small within several weeks or months.

有时开口比正常情况大，并且在出生后无法关闭. 大多数儿童的病因不明. 除了自闭症谱系障碍，一些儿童还可能有其他心脏缺陷.

它是如何影响心脏的?

Normally, 心脏的左侧只向身体泵血, 而心脏的右侧只将血液输送到肺部. 在一个自闭症儿童身上, blood can travel across the hole from the left upper heart chamber (left atrium) to the right upper chamber (right atrium) and out into the lung arteries.

如果ASD很大, the extra blood being pumped into the lung arteries makes the heart and lungs work harder and the lung arteries can become gradually damaged.

如果孔很小，可能不会引起症状或问题. 许多健康的成年人在心房之间的壁上仍然有一个小的开口, 有时被称为卵圆孔未闭 (PFO).

ASD对我的孩子有什么影响?

患有自闭症谱系障碍的儿童通常没有症状. 如果开口小, 它不会引起症状，因为心脏和肺不需要更努力地工作. 如果开口大, the only abnormal finding may be a murmur (noise heard with a stethoscope) and other abnormal heart sounds. 在患有严重自闭症的儿童中, the main risk is to the blood vessels in the lungs because more blood than normal is being pumped there. 随着沙巴足球体育平台的推移，通常是多年，这可能会对肺血管造成永久性损伤.

ASD可以修复吗?

如果开口很小，它不会使心脏和肺部更加努力地工作. 手术和其他治疗可能不需要. 在婴儿身上发现的小自闭症通常会自行闭合或变窄. There isn't any medicine that will make the ASD get smaller or close any faster than it might do naturally.

如果ASD很大, 它可以通过开胸手术关闭, 或者通过心导管插入装置将其堵塞. Sometimes, 如果ASD在心脏中是一个不寻常的位置, or if there are other heart defects such as abnormal connections of the veins bringing blood from the lungs back to the heart (pulmonary veins), ASD不能用导管技术关闭. 那么就需要手术了.

通过心脏直视手术来关闭一个大的ASD通常在儿童早期完成, 即使病人没有什么症状, 防止以后的并发症. 许多缺陷不用补片就能缝合.

ASD维修图

我的孩子会做什么活动?

Your child may not need any special precautions and may be able to participate in normal activities without increased risk. 手术或导管关闭后, 你孩子的儿科心脏病专家可能会建议在短沙巴足球体育平台内改变一些活动. But after successful healing from surgery or catheter closure, no restrictions are usually needed. Sometimes medicines to prevent blood clots and infection are used for a few months after ASD closure.

我的孩子将来需要什么?

这取决于自闭症的类型, your child's pediatric cardiologist may examine your child periodically to look for uncommon problems. 在手术后很短的沙巴足球体育平台内关闭ASD, 儿科心脏病专家必须定期检查孩子. 长期前景非常好, 通常不需要药物，也不需要额外的手术或导尿管.

如何预防心内膜炎呢?

大多数自闭症儿童患心内膜炎的风险并不会增加. Your child's cardiologist may recommend that your child receive antibiotics before certain dental procedures for a period of time after ASD repair. 请参阅 Endocarditis 了解更多信息.

先天性心脏缺陷ID表

更多关于自闭症成人的信息

原因是什么??

原因通常是未知的. 遗传因素有时也会起作用.

它是如何影响心脏的?

如果这个洞很小，它对心脏功能的影响可能很小. 心房之间存在较大缺损时, a large amount of oxygen-rich (red) blood leaks from the heart's left side back to the right side. Then this blood is pumped back to the lungs, despite already having been refreshed with oxygen. 不幸的是，这增加了右侧心脏的工作量.

肺动脉中额外的血流量也会导致逐渐的损伤.

ASD对我有什么影响?

一些ASD患者没有任何症状. 如果开口小, 它不会引起症状，因为心脏和肺做的额外工作很少. 如果开口大，可能会引起轻微的呼吸短促，尤其是在运动时. The increased blood in the lung may increase a patient's susceptibility to pneumonia and bronchitis. 关于身体检查, the only abnormal finding may be a murmur (noise heard with a stethoscope) and other abnormal heart sounds. However, 肺部血管逐渐受损, 肺部压力可能升高, 病人的病情会变得更加严重, 最终患上艾森曼格综合症, 下面描述.

如果我在童年时做过手术来关闭自闭症，我能期待什么呢?

大的ASD通常在儿童早期闭合, 即使病人没有什么症状, 防止以后的并发症. Some defects were closed with a patch of pericardium (the normal lining outside the heart) or synthetic material such as Dacron. 然而，许多需要手术的缺陷可能在不使用贴片的情况下被缝合. The prognosis after ASD closure during childhood is excellent and late complications are uncommon.

如果缺陷仍然存在怎么办? 成年后应该修复吗?

如果开口很小，可能不需要手术或其他治疗.

Most large atrial septal defects now can be closed either with open-heart surgery or during a cardiac catheterization using a device inserted into the opening to plug it (referred to as 介入性或治疗性导尿). However, 如果ASD在心脏中处于不寻常的位置, or if there are other heart defects such as abnormal connections of the veins bringing blood from the lungs back to the heart (pulmonary veins), ASD不能用导管技术关闭. 那么就需要手术了. Even when the defect is discovered in adulthood, patients benefit from closure of large defects.

ASD维修图

你可能遇到的问题

小的未修复或修复的房间隔缺损很少有任何后期问题. Those who have palpitations or who faint need to be evaluated by their cardiologist and may need medical therapy. Also, 如果自闭症谱系障碍是在晚年诊断出来的, 心脏的泵血能力可能受到了影响, 导致心力衰竭. 这种情况需要使用利尿剂, 帮助心脏更好泵血的药物和控制血压的药物. If pulmonary hypertension develops (which is uncommon), some people may need extra medications.

Patients who have had a transient ischemic attack (TIA) or a stroke and are found to have a PFO may be treated with aspirin or another *blood thinner. 如果再次中风复发，服用药物, 患者可能需要关闭PFO或小ASD(见下文)。. There are now special studies in progress to determine whether medications or closure of the PFO is better at preventing stroke. It is important to emphasize that the vast majority of people with small PFOs and ASD's don't have strokes and don't need to have their defects closed.

Ongoing Care

我将来需要什么?

Patients with a history of ASD should be seen periodically by a cardiologist to look for uncommon problems. 在ASD闭合手术后的短沙巴足球体育平台内，心脏病专家必须定期检查你. 长期前景非常好, 通常不需要药物，也不需要额外的手术或导尿管.

医学随访

Sometimes medicines to prevent blood clots and infection are used for a few months after ASD closure. 只有极少数患者在六个月后才需要服药. 如果需要的话，你的心脏病专家可以用无创检查来监测你. These include electrocardiograms, Holter monitors, exercise stress tests and echocardiograms. 它们将有助于显示是否需要更多的手术，比如心导管插入术.

活动的限制

大多数患者, unrepaired atrial septal defects and repaired ASDs do not need any special precautions and may be able to participate in normal activities without increased risk. 近期手术或导管闭合后, 你的心脏病专家可能会建议你在短沙巴足球体育平台内限制身体活动, 即使没有肺动脉高压. After successful healing from surgery or catheter closure, no restrictions are usually needed. 例外情况是，患有肺动脉高压的患者(pulmonary hypertension; see Eisenmenger's syndrome)应该避免高水平的体育运动.

心内膜炎的预防

手术或设备修复后6个月后就不需要了.

Pregnancy

一旦ASD关闭，没有剩余的开口，怀孕的风险非常低. The risk from a pregnancy goes up if there's an unrepaired ASD but pregnancy is usually safe unless there is pulmonary hypertension. A large unrepaired ASD may sometimes lead to heart failure during pregnancy but this is usually well controlled with medication 如果发现得早. 怀孕期间有轻微的中风风险, 因此，建议采取预防血凝块的措施.