The ITE communication is a congenital heart defect that is present at birth. While a baby grows in the womb, a wall called atrial septal is formed, and divides the upper chamber into left and right atrium. Abnormal formation of this wall can cause a hole that remains after birth; this is called atrial septal defect (ASD).


Normally, oxygen-poor blood flows from the body into the right atrium through the right ventricle, and then is pumped to the lungs where it receives oxygen. The oxygen-rich blood returns to the left atrium from the lungs, through the left ventricle and then through the aorta, where it is pumped to the body. ASD allows oxygen-rich blood from the left atrium to pass through the opening in the septum, and then mix with oxygen-poor blood in the right atrium.


There are three mayor types of ASD:

  • Atrial septal defect in the oval fossa: this is the most common defect. It occurs when part of the atrial septum does not fully closed while the heart is developed. This causes the development of an opening between the atria.

  • Ostium primum atrial septal defect: this defect is part of the defects of the atrioventricular (AV) and is often found in a division in the flap of the mitral valve.

  • Venous sinus type atrial septal defect: this defect occurs at the junction of the right atrium and the superior vena cava. In this defect, one or more of the pulmonary veins enter the right atrium instead of correctly entering the left atrium.

Atrial septal defects occurs when the division process does not occur completely leaving an opening in the atrial septum. Some congenital heart defects may have a genetic link, either due to a defect in a gene, a chromosome abnormality, or environmental exposure. This is the cause of the frequent occurrence of heart problems in certain families. Most atrial septal defects occur sporadically for no apparent reason even to develop.


A person who has no other heart defects or which has one small (less than 5mm) may, be asymptomatic, or symptoms may not occur until middle age or later. Symptoms that do occur can begin any time after birth and childhood, these may include: breathing difficulties, frequent respiratory infections in children, sensation of feeling the heartbeat in adults, shortness of breath with activity.


Treatment of CIA is divided into:

  • Medical: is used to treat heart failure at any age. Defects under 6 mm, before one year of age have the possibility of spontaneous closure.

  • Surgical: suggested between 2-4 years of age. It is performed in most cases, under cardiopulmonary bypass.

  • Interventional or surgical minimally invasive: It can be performed by cardiac catheterization, by placing devices fully close the defect.