Chapter 2581： 【2581】Another way

Chapter 2581 [2581] Another way

Normally, the secondary hole closes after the child is born. After the child is born, the pressure in the left atrium is greater than that in the right atrium, and the patch is directly pressed against the hole to erase the hole.

I am afraid of where it is. For some people, the defect is too large, and the patch is not large enough to cover and close, and it is incomplete. This kind of person occupies a certain proportion in the crowd, and it is not low, it can account for 20 to 30 percent. Another major type of atrial septal defect occurs here, called secondary foramen atrial septal defect.

Hearing this, some people can't believe that there are so many people suffering from this disease, because it is rare to hear about such patients around.

This is because most of these human defects have very small pores, which basically do not affect cardiac hemodynamics. The patients are asymptomatic and have not sought medical treatment and are not found, and the discovery does not affect human health. Medically, it is considered that no intervention is required. There is nothing to do to get a knife, right?

Those who need surgery are symptomatic. This symptom is based on the large defect area, and too much blood is poured into the right atrium from the left atrium, resulting in pulmonary hypertension. Continuous pulmonary hypertension will evolve into an organic pulmonary artery disease, and the blood in the right atrium will be re-pressed into the left atrium and left. The ventricle causes symptoms such as cyanosis in left heart failure, an evolution called Eisenmenger syndrome. At this point, we know from previous cases that it is very troublesome, only lung transplantation.

If surgery is to be performed as early as possible, it can be detected and resolved in time. The problem is that the electrocardiogram or chest X-ray of these diseases cannot be detected until there is pulmonary hypertension or arrhythmia.

Even if the area of ​​the defect is large, this type of patient usually shows symptoms of easy colds in childhood, and no other significant symptoms are found, which cannot be detected by ordinary physical examination items.

When I was a teenager, some symptoms appeared, which manifested as shortness of breath more easily than ordinary people.

Our Chinese like to classify such patients as weak constitutions, and we never thought that there would be organic diseases in them. The main reason is that the inspection items are too simple and the necessary screening cannot be done.

Such patients can continue to live without severe pulmonary hypertension. After the age of 40, the symptoms will become more and more serious. At that time, the investigation will finally come out and I will have a heart ultrasound. If I miss the opportunity of surgery for pulmonary arterial hypertension, my life expectancy will be reduced by 10 to 20 years.

For treatment, there is the option of interventional closure after interventional surgery. Like other interventional surgery, there are conditions and thresholds for interventional surgery. If the location of the defect is not good, and the shape of the defect is strange and complicated, interventional surgery cannot be done, and surgery is the only option.

The incidence of this disease in males and females is more than double that of females.

12-bed girl, the admission examination showed that the echo loss in the central part of the atrial septum was about 30mm, and the color blood flow showed left-right shunt at the atrial level. The defect is large and the edges are uneven, and the intervention cannot be transferred to surgery.

Heart surgery is mostly done with two previous median sternum incisions. Today, I heard the teachers discuss in a low voice that it is possible to make a lateral thoracic incision under the right side of the chest.

In the early stage of open heart surgery, a lateral incision was actually used. Later, it was found that incision of the sternum to expose the surgical field is very convenient for doctors to operate. For some very complicated heart diseases, only the sternum can be incised.

In modern times, the right incision has returned to the field of cardiac surgery again. This is because doctors have found that it is no problem to continue to use the right incision for uncomplicated heart disease, and the surgical scar left by the incision in the armpit is easy to hide and hang. The arms are covered, which is in line with the patient's pursuit of beauty.