Many atrial septal defects close spontaneously during childhood. The very small ASD that don’t close can be left untreated, as insignificant. Those ASD that don't close and are of a significant size will need treatment either with catheter intervention or surgery.
Your cardiologist might recommend monitoring your child with annual tests to see if the ASD will get smaller and closes on its own. Monitoring might be needed to allow the child to grow to the adequate size to close the defect
Sometimes medications are recommended to improve physical conditions and to reduce the effects of the ASD on the heart and lungs. In adult patients with a diagnosis of ASD, medications are also prescribed to keep the heartbeat regular or to reduce the risk of blood clots.
Intervention to close ASD
Recommendations are in place to close a medium to large atrial septal defect diagnosed during childhood or adulthood in order to prevent complications.
At present there are two main treatments available:
- Trans – catheter device closure. Specialist cardiologists (interventionists) using as access one of the groins’ blood vessels, insert a thin catheter into a blood vessel and guide it to the heart using X-rays. Through the catheter, a special mesh or plug is positioned to close the hole. The procedure is used to repair secundum type of atrial septal defects only.
- Open-heart surgery. In case of large secundum atrial septal defects, open heart surgery might be required. Surgery is done under general anaesthesia and requires the use of a heart-lung machine. The chest is opened in the midline (breast bone) and surgeons stitch a patch to close the hole.
Patients who have the ASD closed by a device usually stay in hospital a couple of days before been sent home.
After surgery, patients are admitted after the operation to the Intensive Care Unit where they spend at least one day before been transferred to the postoperative ward for a total of 4 to 5 days hospital stay.
Irrespective of the type of treatment, follow up is arranged within a week of the treatment by the cardiologists, usually after one week following discharge from the hospital. Regular follow ups are arranged annually till the child is grown into adulthood.
Adults who've had atrial septal defect repair need to be monitored throughout life to check for complications, such as pulmonary hypertension, arrhythmias, heart failure or valve problems.