The medical assessment of atrial septal defects in pilots

Objective To analyze the aeromedical patho-physiology significance of common atrial septal defects,to discuss appropriate detects and treatment approach for pilots,and to summarize concerned aeromedical assessment.Literature resource and selection Review related references and standards in this field published at home and abroad.Literature quotation Thirty seven research papers and reviews were cited.Literature synthesis Patent foramen ovale and ostium secundum defects arethe common atrial septal defects found in pilots.The aero-physiological significance of atrial septal defects lies in right-to-left shunt (RLS),which may repeatedly occur under aero-circurnstances.RLS may lead to paradoxical embolism,arterial gas embolism and poor hypoxia endurance.By now,whether it is necessary to screen such defects in pilots has not managed to common understanding.Transoesophageal echocardiography is the most effective approach for final diagnosis.On the other hand,contrast transcranial Doppler ultrasound is a reliable alternative way for screening.With the advanced development of micro-invasive methods,percutaneous transcatheter techniques have been successfully used in the treatment of pilots.Conclusion So far,as the high cost of training is concerned,it may be necessary to screen such defects out before the candidates become fighter pilots.Pilots with asymptomatic patent foramen ovale could be qualified for flying,so as to ostium secundum defects in case of conducting successful closure and having stable hemodynamic characteristics. Key words: Heart septal defects,atrial; Heart defects,Congenital; Eligibility determiation