ATRIAL SEPTAL DEFECT (ASD)

A hole in the septum, the wall, between the atria, the upper chambers of the heart. Commonly called an ASD. ASDs constitute a major class of heart formation abnormalities present at birth (congenital cardiac malformations). Normally, when clots in veins break off (embolize) , they travel first to the right side of the heart and, then to the lungs where they lodge. The lungs act as a filter to prevent the clots from entering the arterial circulation. However, when there is an ASD, a clot can cross from the right to the left side of the heart, then pass into the arteries as a paradoxical embolism. Once in the arterial circulation, a clot can travel to the brain, block a vessel there, and cause a stroke (cerebrovascular accident). Because of the risk of stroke from paradoxical embolism, it is usually recommended that even small ASDs be closed (repaired).