Atrial Septal Defect Closure (ASD)

All of us are born with an opening between our upper heart chambers. After birth, the opening usually closes or becomes very small on its own.

However, if the opening doesn't close, blood can travel across the hole between the upper chambers (atria) and out into the lung arteries. The extra blood being pumped into the lungs makes the heart work harder, and the lung arteries can become damaged.

Atrial septal defect (ASD) closure is a type of surgery that closes the hole between the left and right atria of the heart.

Why choose Presbyterian for your atrial septal defect (ASD) closure?

Presbyterian’s Pediatric and Congenital Cardiology team has many different options to help you manage your or your child’s heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans. Depending on the type of heart condition your child has and its underlying cause, the team can recommend a wide variety of treatment options. Our pediatric cardiologists, pediatric interventional cardiologists, and pediatric cardiovascular surgeons work closely together for cases in which cardiac repair or surgery is the best treatment option.

Who is eligible for an atrial septal defect (ASD) closure?

Infants and children with large ASDs are eligible for this surgery. Healthcare providers often do the surgery in infants or children. Sometimes adults also need this type of repair if doctors did not find their ASD during childhood.

If a doctor listens to you or your child's chest and hears a heart murmur, they might suspect it is an ASD. The doctor might want to do one or more of these tests:

• Cardiac catheterization: A thin tube (catheter) is put into a blood vessel at your or your child's groin or arm and guided in toward the heart to see how well it works.


• Echocardiogram: Sound waves are used to produce a video image of the heart. It looks for signs of heart defects. Doctors can use this test to decide with you how to treat your condition.


• Electrocardiogram (EKG): This test records your heart's electrical activity and checks your heart rhythm. Irregular rhythms may be a clue that there is an ASD.


• Imaging: Your doctor may use X-ray, MRI, and CT Scan imaging to see an ASD if an echocardiogram doesn't show it.

What conditions can be treated with an atrial septal defect (ASD) closure?

ASD closure treats an ASD that allows blood to travel across the hole from the left upper heart chambers and forcing the heart to work harder.

Several conditions can be avoided or treated with an ASD closure:

• Stroke.


• Infection.


• Endocarditis.


• Heart failure.


• Excess bleeding.


• Pulmonary hypertension.


• Complications from anesthesia.


• Irregular heart rhythms (called arrhythmia).


• A blood clot, which can lead to stroke or other problems.


• Heart block, which can make a pacemaker necessary.

How do I prepare for an atrial septal defect (ASD) closure?

Your child should not eat or drink anything after midnight before the day of the surgery. Your child may also need to stop taking any medicine beforehand.

Your child’s healthcare provider may want some extra tests before the surgery. These might include chest X-rays, blood tests to check general health, electrocardiogram (EKG), and echocardiogram.

What should I expect during my atrial septal defect (ASD) closure?

During the procedure:

• Your child will be given anesthesia before the surgery starts. It’s usually done through an IV. Your child will sleep deeply and painlessly during the operation. He or she won’t remember it afterward.


• The repair will take several hours.


• The surgeon makes a cut (incision) down the middle of the chest. He or she will separate the breastbone to reach the heart.


• Your child will be attached to a heart-lung machine. This machine will act as your child’s heart and lungs during the procedure.


• The surgeon usually reaches the wall between the septum by looking through one of the heart's valves. The surgeon closes the hole in the septum with a tightly woven patch of material.


• Once the procedure has been completed, your child will be taken off the heart-lung machine.


• Your child’s breastbone will be put back together with wires.


• The surgeon will close the muscle and the skin. A bandage will be applied.

After the procedure:

• The surgical team will take your child to the intensive care unit.


• Medical staff will closely watch your child's heart rate, blood pressure, oxygen levels, and breathing.


• Your child will get pain medicine if needed.


• Your child’s healthcare provider may order follow-up tests, like an electrocardiogram or an echocardiogram.


• By the second day, your child should be up and moving around as much as possible.


• Your child will probably be able to go home about a week after surgery.

How do I care for my child after an atrial septal defect (ASD) closure?

At home after the procedure:

• Your child may temporarily need to take certain medicines after the surgery. Give pain medicines as needed.


• Most children can get back to their normal activities, but they may tire more easily for a while. Children should avoid activities that might result in blows to the chest.


• Your child may need to have stitches removed in a follow-up appointment. Be sure to keep all follow-up appointments.


• Call your child’s healthcare provider if your child has increased swelling, increased bleeding or drainage, a fever, or severe symptoms. A little drainage from the site is normal.


• Follow all the instructions your child’s healthcare provider gives you about medicine, exercise, diet, and wound care.


• For a while after the procedure, your child might need antibiotics before certain medical and dental procedures. They can help prevent an infection of the heart valves.

For a short time after the procedure, your child will need regular checkups by a cardiologist. After that, your child will need to see a cardiologist only once in a while. After recovery, most children can lead normal lives without any activity restrictions.