Atrial Septal Defect Repair in Children—Open Heart Surgery
by Rebecca J. Stahl, MA
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.
Reasons for Procedure
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.
Possible Complications TOP
Complications are rare, but no procedure is free of risk. Possible complications may include:
Some factors that may increase the risk of complications include:
Discuss these risks with the doctor before the surgery.
What to Expect TOP
Prior to Procedure
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.
Description of the Procedure
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.
Immediately After Procedure
Your child will be monitored in the intensive care unit (ICU) with the help of the following devices:
How Long Will It Take?
How Much Will It Hurt?
Pain or soreness during recovery will be managed with pain medicine.
Average Hospital Stay
The usual length of stay is 5-7 days. If there are complications, your child may need to stay longer.
At the Hospital
The hospital staff may:
When your child returns home, do the following:
In about six months, the heart tissue will grow over the sutures or patch.
Call Your Doctor If Any of the Following Occurs TOP
After your child leaves the hospital, call your doctor if any of the following occurs:
Call for Medical Help Right Away 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
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Last reviewed June 2012 by David N. Smith, MD
Last Updated: 6/4/2012