What is an atrial septal defect (ASD)?
An atrial septal defect (ASD) is a hole in the septum, which is the muscular wall that separates the heart’s two upper chambers (atria). An ASD is a defect you are born with (congenital defect) that happens when the septum does not form properly. It is commonly called a “hole in the heart.”
What causes ASDs?
Most congenital heart defects are likely caused by a combination of genetics and factors involving the mother while she is pregnant, as well as diseases such as diabetes, lupus and rubella. About 10 percent of congenital heart problems are caused by specific genetic defects.
What are the long-term effects of atrial septal defects?
Normally, the right side of the heart pumps blood that is low in oxygen to the lungs, while the heart’s left side pumps oxygen-rich blood to the body. When you have an ASD, blood from the left and right sides mix, and can keep your heart from working as well as it should.
What are the symptoms of an ASD?
Many people have no idea they have an ASD because they do not have symptoms. Some patients find out about the defect when a chest X-ray for another problem shows that the right side of the heart is bigger than normal.
By age 50, an ASD can cause symptoms like shortness of breath, fainting, irregular heart rhythms or fatigue after mild activity or exercise.
What are my treatment options?
Treatment for patients with an ASD depends on the type and size of the defect, its effect on the heart, and other health conditions you have, such as pulmonary hypertension, valve disease or coronary artery disease.
In general, treatment is recommended if you have a large ASD that causes significant shunting (flow of blood through the defect) and the right side of your heart is bigger than normal, or you have any of the symptoms described previously. The bigger the defect is, the more shunting you have.
The amount of shunting is measured using echocardiography, MRI or catheterization.
Nonsurgical (percutaneous) repair is the preferred treatment for most patients with ASDs. If you have a different type of ASD, or the anatomy of your ASD is not amenable to percutaneous closure, you may need surgery. Your doctor will let you know which type of repair is best for you.
The device is put in place using a long, thin tube called a catheter. The device is attached to the catheter, which is guided to your heart through a vein in your groin. When the device is released from the catheter, it opens up and seals the hole. Over time, tissue grows over the implant and it becomes part of the heart.
Surgery may be needed to repair large ASDs and other types of ASDs. In some cases, this can be done robotically or with a small incision.
Surgical repair usually involves using a tissue patch to close the ASD. The tissue often comes from your own pericardium (membrane around the heart). Some secundum ASDs can be surgically closed with sutures alone.
If you have questions whether ASD Closure is right for you, call our office at 303-595-2727 to schedule an appointment.