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What is my brother's current heart condition and does he need surgery for his ASD and mitral regurgitation?
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Cancer Care
Question #29618
16 days ago
63

What is my brother's current heart condition and does he need surgery for his ASD and mitral regurgitation? - #29618

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Birth report (new born time) Situs solitus → heart normal position la iruku AV discordance → atrium–ventricle connection normal illa VA discordance → ventricle–artery connection maari iruku Aorta from RV → aorta right ventricle la irundhu poguthu Pulmonary artery from LV → pulmonary artery left ventricle la irundhu poguthu Large non-restrictive VSD → periya hole (ventricles kulla) iruku Bidirectional shunt → blood rendu direction la mix aaguthu No pulmonary hypertension → lungs pressure illa (good) No vegetation/thrombus → clot illa Valves intact → valves ok 👉 Impression: Congenital heart disease Corrected transposition of great arteries (TGA) Large VSD 👶 Age 5 report Situs solitus, Levocardia (SLL) → heart normal side la iruku Atrioventricular discordance → atrium–ventricle mismatch Ventriculoarterial discordance → artery connection mismatch Subpulmonic VSD → hole pulmonary side pakkam iruku Secundum ASD → atrium laum oru hole iruku Pulmonary hypertension (HT) → konjam lung pressure increase No CHF → heart failure illa No PS → pulmonary stenosis illa SR → sinus rhythm (normal heartbeat) 👉 Extra notes: Left coronary artery from right sinus Right coronary artery from left sinus Age 23 – Echo Report (KG Hospital) Corrected TGA → Aorta & pulmonary artery connection maari iruku (birth condition continue) Situs solitus, Levocardia → Heart normal position la iruku (good 👍) AV, VA disconcordant → Heart connections normal illa (expected in TGA) IVC draining into RA → Body la irundhu blood right atrium ku varudhu (normal) 3 Pulmonary veins draining into LA → Lungs la irundhu blood left atrium ku varudhu Aorta draining into RV & PA draining into LV → Artery connections reverse ah iruku Trabeculation seen in RV → Right ventricle muscle structure visible (usually ok) AML small, PML prolapse + moderate mitral regurgitation → Mitral valve la problem → moderate leak iruku 1.3 cm Ostium Secundum ASD → Upper chambers kulla hole iruku (size important ⚠️)but doctor tell printing mistake 1.3mm IVS intact → Ventricles middle wall correct ah iruku (no VSD now) No PDA / PS → Extra defects illa (good 👍) Left arch, No CoA → Aorta structure normal (no narrowing) Normal biventricular function → Heart pumping nalla iruku (very good 👍) No regional wall motion abnormality → Heart muscle movement normal Normal pericardium → Heart outer layer normal Hello Doctor, I’m feeling confused about my brother’s heart condition and would like your guidance. He was diagnosed at birth with congenital heart disease (Corrected TGA with large VSD). At that time and again at age 5, doctors said surgery would be very risky, so it was not done. Now he is 23 years old. His recent echo report shows: - Corrected TGA - 1.3 cm Ostium Secundum ASD (but we were told it might be 1.3 mm – need clarification) - Moderate mitral regurgitation - Normal biventricular function Currently, he does not have major symptoms. I have a few doubts: 1. What exactly is his current condition – is it serious or stable? 2. Is surgery needed now or can it be managed with monitoring? 3. What is his expected long-term outlook (life expectancy)? 4. Should we repeat the echo to confirm the ASD size? Please guide us on what to do next and how to manage his condition properly. Thank you.

How has your brother's overall health been since his last echo?:

- Very good, no issues

Has your brother experienced any new symptoms recently?:

- No new symptoms

What kind of monitoring has he undergone since his last surgery?:

- No follow-up since last echo

What is your brother's current level of physical activity?:

- Very active, exercises regularly

Has there been any family history of heart conditions?:

- No known family history

What did the doctor say about the need for surgery during the last visit?:

- No specific mention of surgery

Is your brother currently taking any medications for his heart condition?:

- No medications
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Doctors' responses

Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
16 days ago
5

Hello dear See as per clinical history it seems presence of Mr valve dysfunction Presence of congenital heart problem Asd or atrial septal defects So you need to undergo follow up with following tests Echo repeat Ct scan/ MRI Serum troponin Serum cck Mb Serum LDH In addition please get in person consultation with cardiologist for following options Asd device replacement Valve replacement Regards

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The current situation for your brother involves a complex congenital heart condition, known as corrected transposition of the great arteries (TGA), coupled with an atrial septal defect (ASD) and moderate mitral regurgitation. Based on the information provided, his heart is functioning adequately without major sypmtoms, which is a positive indicator. However, clarifying the exact size of the ASD is essential, as the difference between 1.3 cm and 1.3 mm is significant. A 1.3 cm hole could imply a larger functional defect, potentially warranting intervention, while 1.3 mm might indicate greater stability.

Currently, his condition seems to be stable, with normal biventricular function suggesting that both heart chambers are pumping effectively. This often reduces the urgency for surgical intervention if he remains asymptomatic. However, moderate mitral regurgitation means some blood is leaking backward through the mitral valve, which is common with heart defects like TGA and can worsen over time.

To address your questions, monitoring is key here. Regular follow-ups with a cardiologist specializing in congenital heart disease is essential. A repeat echocardiogram to confirm the ASD size is advisable to ensure accurate assessment and management. The decision about surgery typically depends on symptoms, progression regarding heart function, pressures within heart and any residual effects.

Longevity can be challenging to predict without knowing specific individual circumstances, but modern advances in managing congenital heart disease have improved long-term outcomes considerably, often allowing a near-normal life expectancy. The need for intervention is complex and should be personalized: regular evaluations will help decide when, or if, surgical intervention is necessary. Keep in close communication with your healthcare provider to effectively manage his condition and prevent any potential complications.

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