How is an atrial septal defect (ASD) treated?

Dr. Daniel P. O'Hair, MD
Cardiothoracic Surgeon

Atrial septal defect (ASD) is a hole in the atrium of the heart, and patent foramen ovale (PFO) is a hole between the two atria. These defects are common structural heart disease conditions.

Not all holes need to be repaired. A clear indication is when a person with a hole in the heart has had a stroke. That means, possibly, that a clot in a vein may have broken off and traveled to the heart and lungs, causing the stroke. A person with a hole in the heart is at great risk for having another stroke. When a person has a whole in the heart, a clot can pass through to the other side of the heart that pumps blood to the brain, which could lead to another stroke or death.

There are different treatment options:

  • Surgery: There are two surgical options for ASD and PFO: traditional open chest surgery through the sternum or robotic surgery, which is performed through a small incision on the right side of the body.
  • Patch: A patch is a catheter-based approach (in which a tube is placed in a vessel and a wire is guided to the problem area) to implant a patch over the hole. The patch covers the hole and prevents blood or clots from passing through.

One or more of the following treatments may be used to treat your atrial septal defect (ASD):

  • Medicines: You may need one or more medicines to treat or prevent problems of your ASD.
  • Surgery: Your doctors ASD repair plan may depend upon the type of ASD you have. It also may depend on where the ASD is in the heart wall. Even if you are having no symptoms, closing an ASD early in life may prevent heart problems in later life. If an ASD is repaired early enough, you may not need any more surgeries for the ASD.
  • Treatment without surgery: Sometimes a man-made umbrella-like patch or plug may be put in place to close the hole. This is done during cardiac catheterization so the person does not need surgery.

A small- to moderate-size atrial septal defect can close by itself over time. However, if an atrial septal defect has not closed by the time a child is about five years old, it probably will not close by itself. When this occurs, many of these defects can be closed using a catheter-based r device (which uses thin, flexible tubes to treat or correct the defect). This relatively new treatment helps avoid the trauma and long recovery of open-heart surgery.

When performed in the hospital’s cardiac catheterization laboratory (or “cath lab”), the procedure involves threading a small, thin tube (a catheter) through a vein to the heart and then delivering the closure device through the catheter to close the atrial septal defect. Patients who undergo this procedure typically go home the same day or soon thereafter.

If the atrial septal defect is too large to be closed with a catheter-based procedure, open-heart surgery may be recommended. During the operation, the surgeon opens the heart and closes the defect using a patch or sutures. The length of stay in the hospital after this surgery may be from three to five days.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.