Why is this procedure done?
An atrial septal defect is an ASD. It is a hole in the heart. The hole is between the two upper chambers of the heart. It is a congenital heart defect which means that your child is born with it. This hole gets in the way of the normal flow of blood through the heart. It allows blood to back up in the lungs. It can cause serious problems like trouble breathing, poor growth, lung problems, and tiredness during activity. ‚
An ASD can be fixed in one of two ways. It may be fixed with open heart surgery or, sometimes, with a special heart catheter. Your childs doctor will talk to you about which procedure is the best one for your child. ‚
When the hole in the heart is closed using a small flexible catheter, it is a transcatheter repair of ASD. This may be done if: ‚
- The hole is small and can be closed using a small device
- Your child's blood vessels are not blocked
- Your child's heart size is normal
- Your child does not have bleeding problems
- There are no other heart defects
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What will the results be?
The hole between the two upper chambers of the heart will be closed. The flow of blood through the heart should return to normal. ‚
What happens before the procedure?
- Your childs doctor will take your child's history. Talk to the doctor about:
- All the drugs your child is taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs your child takes with you.
- Any bleeding problems. Be sure to tell the doctor if you are giving your child any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. Your child may need to stop these drugs as well. Talk to your doctor about them.
- If your child has an illness like a cold or sore throat. This may raise the risk of infection.
- When your child needs to stop eating or drinking before the procedure.
- Your child's doctor will do an exam and may order:
- A recording of your child's heartbeats. You may hear this called an ECG or EKG.
- A test that uses sound waves to make a moving picture of your child's heart. This is an echocardiogram or Echo or 2-D Echo. It is a type of ultrasound of the heart.
- Lab tests
- A picture of your child's chest. This is a chest x-ray.
- You will be asked to sign a consent form for your child before the surgery. You will be told about other options as well as any risks and possible problems. Make sure you ask questions if you do not understand what will occur.
- You may be asked to give your child a bath with a special soap. This will help to prevent infections.
- Your child may be given drugs to prevent infection before and after the surgery.
What happens during the procedure?
- Once your child is in the operating room, they will be given a drug to make them sleepy. It will also help your child stay pain free during the surgery. After your child is asleep, the doctor will put a tube in the mouth to help your child breathe. The staff will put an I.V. in your childs arm to give fluid and drugs. They may also put another small tube in your child's nose. This one goes down into your child's stomach to drain out any fluid or food that might come out during surgery. Your child may have a tube in the bladder to drain urine.
- Monitors will keep track of your child's blood pressure and heart rate.
- Your child's doctor will make a small cut on the skin of the neck or the inner thigh. A small flexible tube called a catheter is put through the cut. It is moved through the blood vessels until it reaches the heart. The doctor uses special tools to watch where the catheter is going. This way the doctor can see the heart structures and the blood flow during the procedure. A special device is put into the hole of the heart. This umbrella-like device closes the hole.
- Then, the doctor will secure the device and pull out the catheter. The cut site is closed and covered with a bandage.
- The procedure takes about 1 to 3 hours.
What happens after the procedure?
- Your child will go to the Intensive Care Unit (ICU) after surgery. The staff will watch your child very closely. They will also give your child drugs for pain through the I.V. as needed.
- Your child will move to a regular hospital room when stable.
- Your child will stay in the hospital for at least 4 to 6 hours after surgery.
- The device placed inside of your childs heart will be covered with new tissue over time.
What drugs may be needed?
The doctor may order drugs to: ‚
- Help with pain
- Prevent infection
- Prevent blood clots
What problems could happen?
- Bleeding. The catheter may cut into a blood vessel.
- Fluid around the heart. This is a pericardial effusion.
- Infection
- Blood clots
Helpful tips
- Talk to your childs dentist about the ASD repair. Your child may need to take drugs to prevent infection before going to the dentist. This is most often needed only during the first 6 months after surgery.
Where can I learn more?
Congenital Heart Information Network ‚
http://tchin.org/resource_room/c_art_14.htm ‚
KidsHealth ‚
http://kidshealth.org/teen/diseases_conditions/heart/asd.html ‚
National Heart Lung and Blood Institute ‚
http://www.nhlbi.nih.gov/health/health-topics/topics/holes/printall-index.html ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚