| What is an ASD? |
During fetal development, the upper chambers of the heart (atria) divide into right and left sides.
In some, the closure is incomplete leaving a "hole in the heart". This hole or defect in the atrial divider (septum) is an Atrial Septal Defect or ASD
Since pressure in the right side of the heart is lower than the left side, blood can flow from the lungs directly through the ASD back to the right heart; re-circulation through the lungs again and again.
This abnormal recycling of blood through the lungs is called "shunting". The amount of blood flowing (or shunting) through the lungs may be many times more than the blood flow to the rest of the body.
Shunting is an extra blood volume to the right side of the heart which can cause an overload of the heart.
This overload can cause enlargement of the heart, abnormal heart rhythm, congestive heart failure, and injury to the arteries of the lungs.
Increased pressure in the right side of the heart may reverse the direction of the shunt. Used blood without oxygen may dilute blood with oxygen levels in the body.
Since the filtering function of the lungs is bypassed, stroke or brain abscess may occur if clots or bacteria cross the ASD into the left side of the heart.
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| How are ASD diagnosed? |
Many ASD's are diagnosed in childhood by examination and echocardiography.
However, ASD's initially do not cause symptoms or prominent murmurs and may not be diagnosed until adulthood.
Ultrasound tests (Echo or TEE) and heart catheterization tests diagnose and measure ASD. |
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| What are my treatment options? |
No treatment
Medicines to treat ASD complications
Open heart surgery to close ASD
Catheter closure of ASD |
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| What are my treatment options?
Medical therapy |
Benefits
Medicines may help symptoms of advanced ASD such as fluid overload or rhythm disturbance. No procedural complications.
Risks
An ASD is a physical mechanical problem which medicines cannot alter or improve
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| What are my treatment options?
Open heart surgery |
Benefits
Established procedure treatments of choice for two of the three types of ASD. Proven to prolong life, reduce heart failure, prevent stroke, and prevent new arrhythmia.
Risks
Procedure complications (5% combined) of death, re-operation, stroke, bleeding, arrhythmia, nerve injury, heart failure, chest scar, infection. Hospitalization 5-7 days. Surgery recovery 45 days. |
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| What are my treatment options?
Catheter ASD Closure |
Benefits
Equal closure efficacy Compared with open heart surgery. Lower complication rate compared with open heart surgery out patient procedure. Return to normal (non athletic) activities in 2 days.
Risks
Procedure complications (2% combined) of death, stroke, bleeding, arrhythmia, device dislodgment, incomplete closure, infection. |
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| How do ASD Devices work? |
The ASD closure device is delivered to the heart through a small catheter or tube.
The catheter is introduced into the body through a major vein in the groin. After the procedure, the catheter is removed and sutures are not needed.
After measuring the ASD size with TEE (echocardiography), a catheter is advanced through the ASD.
The Amplatzer left atrial disc central centering disc are pulled by the catheter into the ASD.
When the Amplatzer centering disk is in place, the right atrial disc is opened and the edges of the ASD are pinched by the left and right disk.
When echo and x-rays images show the device in stable condition, the connection catheter is unscrewed from the device and removed from the body. |
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| How ASD devices heal? |
Within 3-6 months, the normal lining cells of the heart grow over the device, completely covering the artificial materials.
The occluder device becomes part of the atrial septum and blood flows normally. Blood or clots cannot flow through the atrial septum in either direction. |
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| What happens after my ASD closure? |
Most patients leave the hospital the same day as the procedure.
You may resume normal activity in 2 days and vigorous activity in 3-4 weeks.
You must take aspirin for 6 months and plavix for 3 months.
Routine surface echocardiograms are preformed 1 day, 1, 3, 6, and 12 months after the procedure.
Antibiotics are needed before any dental care for 12 months. Avoid routine dental care for the first 6 months
The Amplatzer SO device is made of an alloy and is not effected by MRI scanning or metal detector. |
