Percutaneous Atrial Septal Defect (ASD) Closure

Percutaneous Atrial Septal Defect (ASD) closure

An ASD is a hole in the wall (called the septum) that separates the two upper chambers of your heart—the left and right atria. Normally, blood flows through the heart in a specific direction, but an ASD allows blood to pass abnormally between these chambers.

This extra blood flow can overwork the right side of your heart and lungs, leading to symptoms such as fatigue, breathlessness, and—in the long term—heart rhythm problems, high pulmonary artery pressures or even reduced heart function.

Additional tests you may need

Depending on your condition, your cardiologist may also recommend:

  • Echocardiogram – An ultrasound scan that creates images of your heart using sound waves.
  • Right heart catheterisation – A soft balloon catheter is used to measure pressures in your heart and lungs.
  • Angiogram – A catheter is used to inject contrast dye into your coronary arteries while X-ray images are taken to assess heart function.

How is the procedure done?

  • A small canula or drip will be placed in your arm to allow the medical team to give medications.
  • You will receive a local anaesthetic to numb the area where the catheter is inserted—usually in your groin or wrist.
  • A sedative may be given to help you relax or you may be completely anaesthetised.

Using imaging guidance, your cardiologist will thread a thin catheter through your blood vessels to reach the heart. A specially designed device called a septal occluder is then delivered through the catheter and positioned to seal the hole. This device acts like a plug and stays in place permanently.

Once the device is correctly positioned, the catheter is removed, and the entry site is closed.

What are the risks?

  • Minor bruising or bleeding at the catheter site
  • Temporary or persistent abnormal heart rhythms
  • Swelling or haematoma at the insertion site
  • Sore throat from the anaesthetic tube or imaging probe
  • Changes in blood pressure during the procedure
  • Increased lifetime exposure to X-ray radiation

Less common risks

  • Stroke or mini stroke (TIA)
  • Incomplete closure of the defect, which may require further treatment.
  • Allergic reaction to contrast dye.
  • Blood clots (embolism) that may require blood thinners.
  • Injury to blood vessels or nerves in the groin or neck
  • Tear in the oesophagus, vein, or heart from imaging equipment
  • Deep vein thrombosis (DVT), which may lead to a clot in the lungs.
  • Infection of the closure device, which may require open-heart surgery.
  • Dislodgement of the device, requiring surgical correction
  • Accumulation of blood around the heart, requiring emergency surgery

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