An Atrial Septal Defect, or ASD, is a congenital birth defect, meaning it is present at birth. It is a hole, or flap-like opening, between the top two chambers of the heart and can vary in size and severity. In some individuals, this may cause no issues. For others, this opening can allow blood to flow back and forth between the top two chambers and can cause other health problems if untreated.  

The most common treatment options for Atrial Septal Defect include: 

• A transcatheter based procedure to close the Atrial Septal Defect 
• Open heart surgery 

In this article, we will be highlighting the first option, which is transcatheter based Atrial Septal Defect Closure.

Prior to procedure

You will work closely with your Cardiologist to determine which treatment method for your Atrial Septal Defect closure is the most appropriate. Some testing may be required to determine if transcatheter based closure of the Atrial Septal Defect is an option for you.

Your Cardiologist may order the following tests in determining a treatment plan for you: 

• Cardiac MRI and/or Cardiac CT
• Right Heart Catheterization
• An ultrasound of your heart to visualize and confirm the Atrial Septal Defect exists

Additional testing may be ordered at the discretion of your provider to rule out other disorders or health conditions. 

Procedure Overview

Transcatheter closure of the Atrial Septal Defect is completed by a small plug that looks like two discs in the septum of your heart to stop blood flowing from one chamber to the other. 

For your procedure, the doctor will have you come to the heart catheterization lab where you will be given IV sedation. After the sedation is administered, a breathing tube is placed and an ultrasound probe is guided down your esophagus to provide images of the Atrial Septal Defect throughout the procedure. Local anesthetic is used to numb the area where the Doctor will make an incision by your hip bone. 

From the incision by your hip bone, a hollow tube, also known as a catheter, will be inserted into the vein and threaded up to the inside of your heart.

The ASD Closure device will be introduced through the heart catheter and into your heart. Once in the correct position, the Doctor will allow the ASD Closure device to open in the hole, or Atrial Septal Defect, that exists in your heart, one disc at a time.   

Once the device is in a suitable position, preventing flow from going between the top two chambers of your heart, the breathing tube and ultrasound probe will be removed and you will complete a period of bedrest. You will likely spend the night in the hospital after your procedure.

Risks and Benefits

Benefits of this procedure include improvement in breathing and swelling, while also reducing the possibility of irregular heart rhythms. Other benefits include reduced hospital stay when compared to the alternative of open heart surgery. The most common risks associated with this procedure are incision-site bleeding, bruising, and sore throat. Patients may also experience bruising if medications are changed post-procedurally. Other risks include, but are not limited to: 

• Stroke
• Heart attack
• Kidney failure
• Air embolism
• Blood vessel injury
• Injury to the heart
• Infection
• Pericardial effusion
• Device related thrombosis
• Death

Recovery

After the procedure is completed, you will complete a period of bedrest determined by the Doctor who performed your procedure. Plan on spending the night in the hospital. You will likely have some brief limitations set by your Doctor. You will have limitations for visiting the dentist following your procedure. 

Monitor your incision a few times a day in the first days following your procedure. 

Follow-Up

Once your procedure is completed, you will need to be seen in clinic for follow-up at certain time intervals. Imaging of your ASD Closure Device will be completed.