ASD closure is a procedure to close an atrial septal defect (ASD). An ASD is a hole in the heart between the two upper chambers. The procedure uses a device to plug the hole, a patch to cover it or sutures to sew it shut. It may involve open-heart surgery or a minimally invasive procedure using a catheter to place the closure device.
ASD closure is a procedure to close an atrial septal defect (ASD) or hole in your heart.
An atrial septal defect (ASD) is an abnormal opening in the wall (septum) between your heart’s two upper chambers (atria). Every baby is born with a small opening there. The hole usually closes a few weeks or months after birth. But sometimes a baby is born with a larger hole that doesn’t close properly.
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If the hole is small, it may not cause any problems or need treatment. But if the ASD is large, it can allow blood to leak into the wrong chambers of your heart. This can make your heart and lungs work harder, causing symptoms and complications, including:
Your healthcare provider may suggest ASD closure if you’re at risk for those complications. They also might recommend the procedure if you’re already having surgery for another congenital heart defect.
Surgeons often perform ASD closure on young children to avoid future heart damage and complications.
ASD closure is performed by a heart surgeon or interventional cardiologist, both specialists in heart procedures.
There are several techniques for ASD closure. It may require open-heart surgery. Sometimes, it can be accomplished with a minimally invasive procedure called cardiac catheterization using a catheter threaded from a vein in your groin up to your heart.
The hole can be:
Your healthcare provider will recommend the appropriate technique for you, depending on:
Some medical facilities even use robotic-assisted surgery to repair an ASD.
During surgery for ASD closure, you’re under general anesthesia. You receive medications that put you to sleep, so you feel no pain during the operation.
A healthcare provider connects you to several machines that monitor your vital signs, including heart rate and breathing. They also connect you to a heart-lung machine to take over the work of your heart during the procedure.
Your heart surgeon makes an incision (cut) in your chest. Your surgeon may make the incision:
Your surgeon then uses a special tool to spread your ribs. Using an endoscope, a thin tube with a light and camera at the end, your surgeon locates the ASD. Then they close it with a plug, patch or sutures.
If you have a smaller ASD and no other heart conditions that need correcting, you may be able to have transcatheter ASD closure. This method is less invasive and generally makes recovery easier and faster.
For transcatheter ASD closure, you may receive general anesthesia or medications that sedate you. Sedation makes you sleepy and relaxed, but you’re still conscious (unlike general anesthesia).
To perform a transcatheter ASD closure, your interventional cardiologist:
After ASD closure, your healthcare team monitors you as you recover from anesthesia. They also take images of your heart to make sure the procedure was successful. You typically stay in the hospital for one or more nights, depending on the type of procedure you had.
ASD closure can reduce the symptoms and complications associated with a hole in your heart. This can protect your heart and lungs, helping you live a longer, more productive life.
ASD closure is usually safe and effective, but it does carry some risks, including:
Some complications can be life-threatening.
Your healthcare provider will talk to you about what to expect during recovery. You may have to limit physical activity for a few weeks especially if you have surgical ASD closure. For transcatheter closure, you should be able to resume your normal activity within one week.
You’ll likely need to take medications to prevent blood clots for six months after the procedure. You’ll need to take antibiotics to prevent infections, especially when you’re planning dental procedures at least within the first six months after the procedure.
It’s essential to attend all follow-up appointments with your cardiologist or surgeon. The doctor will perform tests to ensure the procedure was effective. Tests may include:
Occasionally, some people need repeat surgery to close an opening left behind after ASD closure or a reopened hole. But this is rare, and a repeat procedure is necessary only if the hole is large enough to cause problems.
Studies show that a younger person (25 or younger) who’s had ASD closure has about the same life expectancy as other people the same age who never had an ASD. But older individuals who receive ASD closure have a slightly shorter lifespan than their counterparts who haven't had ASD closure.
Importantly, people with an ASD who get the hole closed live longer than people with an ASD who don't have the procedure.
After ASD closure, there are risks of serious complications like infection, heart problems and stroke. Seek medical attention right away if you experience any signs of a complication, such as:
A note from Cleveland Clinic
ASD closure is a procedure to close an atrial septal defect (ASD) or hole in the heart. If you or your child has an ASD, talk to your healthcare provider about the benefits of closure. They’ll help you understand which treatment is right for you.
Last reviewed by a Cleveland Clinic medical professional on 03/08/2022.
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