Cardiovascular system Interatrial and interventricular communications
Interatrial and interventricular communications: The cardiac septum is a muscular wall that divides the right and left sides in the heart, so preventing that the venous blood (low in oxygen) to be mixed with the arterial blood (high in oxygen). The atrial septum separates the right atrium from the left atrium (the two upper chambers in the heart), while the ventricular septum separates the right ventricle from the left ventricle.
An interatrial communication (IAC) is a defect (hole) between both atria, while the interventricular communication (IVC) is an opening between both ventricles. Though these are congenital (birth) defects, they can sometimes only diagnosed in older children and even adults.
In such defects, there is a blood mixture from the left side of the heart to the right one or vice-versa. So causing a heart overload and a larger flow to the lungs. If these are not treated, they can cause an increase in the heart size, arrhythmias, and pulmonary hypertension. Small IVC in children can close spontaneously. The IAC usually requires treatment, as it does not close alone. An echocardiogram aids in a more detailed evaluation on the defect and the size of the heart and in an estimate of the pulmonary pressure.
Intervention-Procedure
When an intervention is indicated, the defects are corrected by surgery. In such surgery, the IAC can be closed directly or by the placement of a pericardial patch from an ox or the patient himself/herself (in large defects). The IVC usually require the use of patches for their closure. It is important to perform the surgery before irreversible alterations (such as a significant increase in the heart size and pulmonary hypertension) are set, as then the surgery is not possible anymore in certain cases.
A new alterative for selected cases is the percutaneous closure, where an umbrella-type prosthesis is used and inserted by the groin, going until the defect place. This is a more recent procedure and we should wait for long-term results for a proper evaluation of its role.
Support notes
Echocardiogram: Exam that uses ultrasound to evaluate the heart. Click here to go to the page of Echocardiogram and to know more about this subject.
