Atrial Septal Defect
Treatment

In the past, atrial septal defect (ASD) closure required open heart surgery through an incision in the chest using a heart-lung bypass machine, followed by three to five days in the hospital for recovery.

Today, it's possible to close an ASD without surgery using a procedure called cardiac catheterization, performed in our Pediatric Cardiac Catheterization Laboratory. The procedure takes about three hours. Most patients go home the same day or stay one night in the hospital. If an ASD is unusually large, however, catheter closure may not be possible. In these cases, surgical closure is necessary and will be scheduled for another time.

During the procedure, a catheter — a flexible, narrow tube — is inserted through a tiny incision in the groin and into blood vessels. The tube is directed to the heart, where X-ray and video images are taken with an echocardiogram to assess the size and location of the ASD. Based on this information, an appropriately sized atrial septal repair device is selected.

An atrial septal repair device consists of two patches that are permanently placed in the ASD hole to cover the heart's left and right atriums. Within the first six months after placement, the lining of the heart wall grows over the device, eventually covering and sealing the hole. There are several devices currently available for closure. The type and size of device is chosen after X-ray and echocardiogram images to determine the size and location of the ASD. Sometimes, more than one device is needed.

Catheter closure is a safe and effective procedure, with a success rate of more than 97 percent. A small number of patients require surgical closure after catheterization because the hole is too large or not centered in the atrial wall. After catheter closure of an ASD, patients must take aspirin every day for six months to prevent blood clots from forming on the device and to help the lining of the heart grow over the device.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.
Last updated July 14, 2010