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What Is ASD (Atrial Septal Defect) Closure?

ASD closure is a medical procedure performed to correct a hole in the wall (septum) that separates the heart's two upper chambers (atria). This hole, known as an atrial septal defect, allows oxygen-rich blood to flow from the left atrium into the right atrium, overloading the right side of the heart and lungs. Closure of this defect helps restore normal blood circulation and prevents complications such as heart failure, stroke, or pulmonary hypertension.

Why Does an Atrial Septal Defect Need to Be Closed?

If left untreated, an ASD can cause long-term issues. The extra blood flowing to the right side of the heart makes it work harder, leading to enlargement and weakening over time. This increased blood flow can also damage the lungs' arteries. Even if a person does not show symptoms in childhood, complications can arise in adulthood. Closing the defect prevents these risks and improves heart efficiency.

How Is ASD Diagnosed Before Closure?

Doctors use imaging techniques such as echocardiography, cardiac MRI, or transesophageal echocardiogram (TEE) to visualize the heart and confirm the presence and size of the defect. Sometimes, a cardiac catheterization is performed to assess the pressure in the heart and lungs and to determine whether closure is necessary and which technique should be used.

What Are the Options for ASD Closure?

ASD can be closed through two main methods: minimally invasive catheter-based closure or open-heart surgery. The method depends on the size, location, and type of defect. Catheter-based closure is preferred for secundum-type ASDs with adequate rim of tissue, while surgery is needed for larger, more complex, or non-secundum defects.

What Happens During Catheter-Based ASD Closure?

In this procedure, a thin, flexible tube (catheter) is inserted through a vein in the groin and guided to the heart. Using imaging guidance, a closure device is deployed across the defect, which expands on either side of the hole and seals it. Over time, heart tissue grows over the device, permanently closing the hole. This technique is minimally invasive, does not require opening the chest, and has a quicker recovery.

When Is Surgical ASD Closure Necessary?

Surgical ASD closure is usually reserved for very large defects, multiple holes, or when catheter-based closure is not feasible. It involves opening the chest and placing sutures or a patch over the defect under general anesthesia. This method is effective and safe, especially in children or adults with more complex heart anatomy. Recovery time is longer than catheter-based procedures but results are often excellent.