An atrial septal defect is a hole in the wall between the two upper chambers (right and left atriums) of the heart. Open heart surgery can repair the hole, either by closing the hole with stitches or by placing a patch over it.
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If a child is born with a hole between the upper chambers of the heart, the blood can flow backward into the right side of the heart and into the lungs. This triggers the heart to work harder. Over time, this can lead to damage to blood vessels in the lungs and congestive heart failure. This procedure is done to fix the hole.
Most children who have this surgery will have good outcomes.
Complications are rare, but no procedure is free of risk. Possible complications may include:
Before your child's procedure, talk to the doctor about ways to manage factors that may increase your child's risk of complications such as chronic disease such as diabetes or obesity. Low birth weight or a recent infection may increase the risk of complications.
The doctor will examine your child. The doctor may order tests, like:
The doctor will tell you if your child needs to stop taking medicines. Ask the doctor when your child should stop eating or drinking before the surgery.
General anesthesia will be used. It will block pain and keep your child asleep through the surgery.
First, the doctor will cut through the skin and breastbone. The chest cavity will be opened. Next, the heart will be connected to a heart-lung machine. This machine will take over the functions of the heart and lungs. The doctor will stop the heart to do surgery.
The pericardial sac around the heart will be opened. The doctor may remove a small part of this sac and use it to patch the hole. A cut will be made in the right atrium. A small hole will be closed with sutures. A larger hole will be covered with a patch that is made of the sac or other material. Once the defect is repaired, the doctor will close the incision. The heart will then be restarted. Once it is working fine, the heart-lung machine will not be needed. The doctor will close the chest cavity. Sutures will be used to close the skin.
Your child will be monitored in the intensive care unit (ICU) with the help of the following devices:
Pain or soreness during recovery will be managed with pain medicine.
The usual length of stay is 5-7 days. If there are complications, your child may need to stay longer.
The hospital staff may:
During your stay, the hospital staff will take steps to reduce your child's chance of infection such as:
There are also steps you can take to reduce your child's chances of infection such as:
When your child returns home, do the following:
In about six months, the heart tissue will grow over the sutures or patch.
After your child leaves the hospital, call your doctor if any of the following occurs:
Call for medical help or go to the emergency room right away if any of the following occurs in your child:
In case of an emergency, call for medical help right away.
American Heart Association
National Library of Medicine
Heart and Stroke Foundation
Baylor College of Medicine. Atrial septal defect. Baylor College of Medicine website. Available at: http://www.debakeydepartmentofsurgery.org/home/content.cfm?proc_name=atrial+septum+defect+repaircontent_id=274. Updated April 2010. Accessed April 21, 2010.
Cardiothoracic Surgery. Atrial septal defect (ASD). Cardiothoracic Surgery website. Available at: http://www.cts.usc.edu/atrialseptaldefect.html. Accessed April 21, 2010.
Children’s Hospital Boston. Atrial septal defect. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site477/mainpageS477P0.html. Accessed April 21, 2010.
Cincinnati Children’s Hospital. Open-heart surgery. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/heart-encyclopedia/treat/surg/open.htm. Updated July 2009. Accessed April 21, 2010.
Cornell University. Taking care of your child after heart surgery. Cornell University website. Available at: http://www-users.med.cornell.edu/~spon/picu/parents/peddcwd.htm. Updated November 2001. Accessed April 21, 2010.
Cove Point Foundation. Atrial septal defect. Cove Point Foundation website. Available at: http://www.pted.org/?id=atrialseptal4. Updated April 2009. Accessed April 21, 2010.
Durham L, Mendelsohn A. Atrial septal defects: surgical and transcatheter management. Congenital Heart Information Network website. Available at: http://tchin.org/resource_room/c_art_14.htm. Updated May 2003. Accessed April 21, 2010.
Kids Health. Atrial septal defect. Kids Health website. Available at: http://kidshealth.org/parent/medical/heart/asd.html#. Accessed April 21, 2010.
Last reviewed June 2013 by Michael J. Fucci, DOLast Updated: 1/27/2014