Atrial Septal Defect Surgery

The four chambers of the heart (atria and ventricles) are separated by a muscular wall called the septum. The portion of the septum that separates the two upper chambers is called the “atrial septum,” while the one that separates the two lower chambers is called the “ventricular” septum. Every child is born with a small opening separating the two upper chambers. After birth, the opening is no longer needed and usually closes within weeks or months.

If the hole within the upper chambers does not close, a congenital heart defect (present at birth) known as atrial septal defect (ASD) arises. Depending on your condition and the size of the ASD, your doctor will decide at what stage in your life to proceed with surgery.

Closure of some atrial septal defects can be performed by transcatheter technique which does not involve cutting the chest open. However most atrial septal defects will require open-heart surgery. Open-Heart surgery can sometimes require cutting the middle of the chest while in some situations a small limited incision in the chest can accomplish the procedure. The type of method chosen will vary according to your specific medical condition and on the size and location of the atrial septal defect.

How to Prepare for the Procedure

Before the procedure, your doctor and treatment team will explain to you what to expect before, during and after the procedure and potential risks of the procedure. Talk to your doctor about:

  • All medications, herbal products and dietary supplements you are currently taking and ask for their recommendations about each.
  • Diabetes and how to adjust your medicine on the day of the procedure.
  • Radiation exposure, especially for those that are pregnant.
  • Any allergies to medicines, latex, tape, iodine, and anesthetic agents.
  • Any history of bleeding disorders.
  • Any implanted device (e.g. pacemaker or ICD).
  • Any body piercings on your chest or abdomen.

Other recommendations include:

  • Eat a normal meal the evening before the procedure. However, do not eat, drink or chew anything after midnight before your procedure. If you must take medications, only take them with sips of water.
  • Leave all jewelry at home.
  • Remove all makeup and nail polish.
  • Wear comfortable clothing when you come to the hospital.
  • If you normally wear dentures, glasses, or hearing devices at home, plan to wear them during the procedure.

What to Expect Before the Procedure

Before the procedure, your doctor may perform a variety of diagnostic tests, including:

What to Expect During the Procedure

Depending on your medical condition as well as the size of the atrial septal defect, your doctor will choose the appropriate method for the procedure. For small defects, your doctor will most likely use a transcatheter technique. This method usually takes 1-2 hours, but preparation and recovery may add several hours. The procedure is usually performed in the cardiac catheterization lab. Check with your doctor about the details of the procedure. In general, during an atrial septal defect closure (transcatheter technique):

  • You will change into a hospital gown.
  • A nurse will start the intravenous (IV) line in your arm which will administer medications and fluids during the procedure.
  • Prior to starting the procedure, you will receive a local anesthetic at the site of where the catheter will be inserted (typically groin). Your doctor will then make a small puncture at this site.
  • Through this small puncture, your doctor will insert the catheter. Within the catheter there’s a small device inside of it.
  • Your doctor will guide this catheter to the atrial septum.
  • Once the atrial septum is reached, your doctor will deploy the small device and therefore close the hole.
  • Once the procedure is complete, the catheter will be removed and the incision will be closed with sutures or bandages.

What to Expect After the Procedure

After the procedure, you will be taken to the recovery unit for further observation for several hours. You may need to stay overnight. Other recommendations include:

General Guidelines

  • Your vital signs, such as heart rate and breathing, will be watched.
  • You may need to lie flat for several hours after the procedure without bending your legs.
  • You may receive anticoagulants to keep blood from clotting.
  • You may receive pain medicine if needed.
  • Your doctor will give you instructions to follow during your recovery.
Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
Children's Hospital of New Jersey at Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000

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