Atrial Septal Defect (ASD) Closure
Atrial septal defect (ASD) closure is a medical procedure used to repair an abnormal opening in the wall that separates the upper chambers of the heart (atria). This condition, known as an atrial septal defect, is a type of congenital heart defect present from birth.
If the hole does not close naturally within a certain period, your doctor may recommend closure to prevent long-term complications. ASD closure can be performed using minimally invasive catheter-based techniques or, in some cases, through open-heart surgery, depending on the size and location of the defect. A special closure device or surgical patch is used to seal the hole.
What does it do?
ASD closure addresses the abnormal opening between the atria, helping to prevent complications caused by abnormal blood flow. Small ASDs may cause no symptoms and can sometimes close on their own. However, larger ASDs allow blood to flow between the chambers, increasing pressure on the heart and lungs.
Closing the defect reduces the risk of:
- Arrhythmias (irregular heartbeats)
- Stroke
- Pulmonary hypertension
- Heart failure
This procedure helps restore normal blood flow through the heart and prevents future health issues.
How does it work?
ASDs develop during fetal growth when the heart wall between the atria fails to form completely. If the hole persists after birth and is significant in size, it may allow oxygen-rich blood to mix with oxygen-poor blood, overloading the lungs and stressing the heart.
Diagnosis typically involves imaging tests such as:
- Echocardiogram
- Electrocardiogram (ECG)
- Chest X-ray
- CT or MRI scans
If closure is recommended, the hole is sealed either through a catheter-based closure device or a surgical patch. Over time, the body’s tissue grows over the patch or device, forming a permanent part of the heart wall.
Why is it performed?
Many ASDs are asymptomatic, especially small ones. However, larger defects may cause symptoms or lead to long-term damage if left untreated.
Common reasons for closure include:
- Ongoing fatigue
- Heart murmur
- Breathlessness
- Irregular heart rhythm (arrhythmia)
Surgical repair is generally advised if the defect is large enough to cause strain on the heart and lungs or if complications have already developed.
The procedure
The method used will depend on the size, location, and type of ASD, as well as the patient’s overall health:
Minimally Invasive (Percutaneous) Approach:
- Local anaesthetic is applied to the groin area
- A catheter carrying the closure device is inserted into a vein
- The catheter is guided to the heart and positioned at the defect site
- The device is deployed to seal the hole
Surgical Approach:
- General anaesthetic is administered
- A heart-lung bypass machine supports circulation
- An incision is made in the chest
- The defect is repaired using a surgical patch
The chest is closed and the wound dressed
Recovery
After ASD closure, your progress will be carefully monitored. Imaging tests may be performed to confirm the success of the procedure. Your care team will provide guidance on:
- Wound care
- Medication, if required
- Follow-up appointments to monitor recovery and heart function
Most patients recover well, with many able to return to normal activities after a short period, especially following the minimally invasive approach.