Atrial Septal Defect Closure
Atrial Septal Defect Closure
An ASD is a congenital heart defect that means a hole is present in the wall that separates the upper chambers of the heart (the atria). ASD closure is performed to close this hole, restoring normal blood flow through the heart.
Atrial Septal Defect (ASD) can allow blood to flow abnormally between the heart chambers and put extra strain on the heart and lungs. An ASD closure aims to correct this defect, improving heart function and reducing the risk of long-term complications. It is typically recommended when the defect is causing significant symptoms or increasing the risk of heart and lung problems.
ASD closure can be performed in two main ways:
- The catheter procedure: This requires a small device called a catheter to be inserted through a blood vessel in the groin and guided up to the heart, where it seals the hole. This technique is minimally invasive and often preferred for smaller defects.
- Open-heart surgery: If the defect is large or has a complex shape, this procedure is recommended. The heart is accessed directly, and the hole is either sewn shut or covered with a patch.
Preparing for your visit
The procedure will take place at a hospital. You will be given a check in time and have consultation with the surgical team before the procedure.
The duration of the ASD closure procedure can vary. A catheter-based closure is typically completed within 1 to 2 hours and open-heart surgery is generally completed within 3 to 4 hours however we recommend speaking to your specialist about hospital preparation and recovery time.
During an ASD closure, you will be placed under anaesthesia to ensure you remain comfortable and do not feel any pain. The procedure usually starts with your doctor making a small incision, often in the groin area, to insert a catheter (for minimally invasive closure) or making a chest incision (for open surgery). The procedure is carefully monitored using imaging to guide the catheter or surgical instruments to the heart. Once the defect is successfully closed, the catheter is removed, and the incision is closed.
For a catheter-based closure, general anaesthesia is typically used, meaning you will be completely asleep during the procedure. For open-heart surgery, anaesthesia is also required, along with additional support to temporarily take over heart and lung function during the procedure.
- Intensive Care Unit (ICU): The initial post-surgery recovery occurs in the Intensive Care. For the first 4-6 hours you will remain anaesthetised with full life support until the team are happy to start turning off the anaesthesia drugs and allowing you to wake. Most people would then expect to remain in the ICU for 2 or 3 days for monitoring after their surgery.
- Cardiac Ward: After the ICU stay, people are transferred to the Cardiac ward, where the aim is to improve mobilisation and encourage physical recovery. Painkillers are taken away as tolerated, and other medications reintroduced as able. A usual hospital stay would be between 5 and 10 days for most open-heart procedures with Sternotomy.
- Post Discharge from Hospital: Most people are safe to return straight home from hospital after the initial stay. They will be able to feed, shower and dress themselves. They will need to start walking around and outside the house regularly and aim to increase the amount of walking over the first 6 weeks, so they are doing 30-45minutes 2 or 3 times a day. The amount depends on their ability and comfort levels.You should not be lifting anything heavier than 2 kg (think about a 2litre milk carton) for the first few weeks after surgery and slowly can increase to 5 kg total around 6 weeks post. You should not do any housework for the first 6 weeks. Especially avoid vacuuming and sweeping. Don’t mow the lawn until you have spoken to the surgeon.
- Inpatient Rehabilitation: This usually occurs if somebody has limitations that make them unsafe for return home with their family, or if they have nobody that can come in and check on them after hospital discharge. Less than 10% of people will require inpatient rehab.
- Driving after heart surgery: You are not allowed to drive a car after heart surgery for the first 6 weeks, or until review and clearance by your treating doctor. This could be your surgeon or your cardiologist. You will not be covered by your insurance if something happens while driving before receiving a clearance. You don’t need to surrender your licence but do need to be sensible regarding this.
