An atrial septal defect is a hole in the wall between the two upper chambers (right and left atriums) of the heart. A transcatheter procedure is a minimally-invasive way to repair the hole. During this procedure, a device is implanted to seal the hole. As your child recovers, the device will trigger the heart tissue to grow. The tissue will slowly grow over the hole.
If a child is born with a hole between the upper chambers of the heart, the blood can flow backward into the right side of the heart and into the lungs. This triggers the heart to work harder. Over time, this can lead to damage to blood vessels in the lungs and congestive heart failure . The procedure is done to fix the hole.
Blood Flow Through the Heart
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Most children who have this procedure will have good outcomes.
Complications are rare, but no procedure is free of risk. Possible complications may include:
Before your child's procedure, talk to the doctor about ways to manage factors that may increase your child's risk of complications such as chronic disease such as diabetes or obesity. Low birth weight or a recent infection may increase the risk of complications.
The doctor will do a physical exam of your child. Tests may include:
The doctor will tell you if you child needs to stop taking certain medicine. Ask the doctor when your child should stop eating or drinking before the surgery.
General anesthesia will be used. It will block any pain and keep your child asleep through the surgery. It is given through an IV in the hand or arm.
Your child will receive IV fluid and medicines through a vein in his arm. The catheter (small tube) will be inserted either in the arm or groin. Next, electrodes will be placed on the chest. These electrodes will send information to the EKG machine, allowing the doctor to monitor the heart.
A catheter will be inserted in the blood vessel and advanced so the end is in the heart. Dye will be injected to allow the doctor to view x-ray images of the heart. An echocardiogram may also be used. Before the hole can be covered, the doctor will need to find out the size of the hole. A catheter with a balloon attached to it will be sent to the upper chambers of the heart. The balloon will inflate and measure the hole.
Once the doctor knows the size of the defect, another catheter will be sent to the heart. This catheter will have a device attached. There are different types of devices available. Some are able to open so that the hole is covered on both sides. Other devices open like an umbrella to cover the defect. Once the device is placed, the doctor will remove the catheter. Lastly, a bandage will be placed over the insertion site.
Your child will be closely monitored in the intensive care unit (ICU). The hospital staff will:
Your child will have pain and soreness. The doctor will give pain medicine.
The usual length of stay is 2-4 days. In some cases, your child may be able to go home as soon as the next day. The doctor may choose to keep your child longer if there are complications.
When your child is recovering at the hospital, the hospital staff may:
During your stay, the hospital staff will take steps to reduce your child's chance of infection such as:
There are also steps you can take to reduce your child's chances of infection such as:
When your child returns home, do the following:
After your child leaves the hospital, call the doctor if any of the following occurs:
Call for medical help or go to the emergency room right away if any of the following occurs in your child:
In case of an emergency, call for medical help right away.
American Heart Association
National Library of Medicine
Heart and Stroke Foundation
Baylor College of Medicine. Atrial septal defect. Baylor College of Medicine website. Available at: http://www.debakeydepartmentofsurgery.org/home/content.cfm?proc_name=atrial+septum+defect+repaircontent_id=274. Updated April 2010. Accessed April 21, 2010.
Cardiothoracic Surgery. Atrial septal defect (ASD). Cardiothoracic Surgery website. Available at: http://www.cts.usc.edu/atrialseptaldefect.html. Accessed April 21, 2010.
Children’s Hospital Boston. Atrial septal defect. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site477/mainpageS477P0.html. Accessed April 21, 2010.
Cincinnati Children’s Hospital. Open-heart surgery. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/heart-encyclopedia/treat/surg/open.htm. Updated July 2009. Accessed April 21, 2010.
Cornell University. Taking care of your child after heart surgery. Cornell University website. Available at: http://www-users.med.cornell.edu/~spon/picu/parents/peddcwd.htm. Updated November 2001. Accessed April 21, 2010.
Cove Point Foundation. Atrial septal defect. Cove Point Foundation website. Available at: http://www.pted.org/?id=atrialseptal4. Updated April 2009. Accessed April 21, 2010.
Durham L, Mendelsohn A. Atrial septal defects: surgical and transcatheter management. Congenital Heart Information Network website. Available at: http://tchin.org/resource_room/c_art_14.htm. Updated May 2003. Accessed April 21, 2010.
Kids Health. Atrial septal defect. Kids Health website. Available at: http://kidshealth.org/parent/medical/heart/asd.html#. Accessed April 21, 2010.
Last reviewed June 2013 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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