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 fix 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 is done to fix the hole.
Most children who have this surgery will have good results.
Problems are rare, but no procedure is free of risk. Some problems may be:
Before surgery, talk to the doctor about ways to manage things that may raise your child's risk of problems such as chronic diseases like diabetes or obesity. Low birth weight or a recent infection may raise the risk of problems.
Your child may have:
The doctor will tell you if your child needs to stop taking medicine. 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.
A cut will be made in the skin and breastbone. The chest will be opened. Next, the heart will be connected to a heart-lung machine. This machine will take over the work of the heart and lungs. The heart will be stopped to do surgery.
The pericardial sac around the heart will be opened. A small part of this sac may be removed and used 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 cut will be closed. The heart will then be restarted. Once it is working fine, the heart-lung machine will not be needed. The chest will be closed. Sutures will be used to close the skin.
Your child will be watched in the intensive care unit (ICU) with the help of:
Pain during recovery will be managed with pain medicine.
The usual length of stay is 5 to 7 days. If there are problems, your child may need to stay longer.
The staff may:
During the stay, staff will take steps to lower your child's chance of infection such as:
There are also steps you can take to lower your child's chances of infection such as:
When your child returns home:
In about 6 months, the heart tissue will grow over the sutures or patch.
Call your child's doctor if your child is not progressing or your child has problems such as:
Call for medical help or go to the emergency room right away if any of the following occur in your child:
In case of an emergency, call for emergency medical services right away.
American Heart Association
National Heart, Lung, and Blood Institute
Heart and Stroke Foundation
Atrial septal defect. Cove Point Foundation website. Available at: http://www.pted.org/?id=atrialseptal4. Updated January 24, 2017. Accessed June 26, 2018.
Atrial septal defect. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/medical/heart/asd.html. Accessed September 2016. Accessed June 26, 2018.
Open-heart surgery. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/heart-encyclopedia/treat/surg/open.htm. Updated June 2015. Accessed June 26, 2018.
Last reviewed June 2018 by Karri Kassir, MD Last Updated: 1/27/2014