An atrial septal defect is a hole in the wall between the 2 upper chambers (right and left atriums) of the heart. Open heart surgery can close the hole. The hole may be stitched shut, patched over, or plugged with a device. In about 6 months, the heart tissue will grow over the sutures or patch.
An atrial septal defect can cause blood to 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 surgery is done to fix the hole.
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
Things that may raise the risk of problems are:
The surgical team may meet with you to talk about:
General anesthesia will be used. Your child will be asleep.
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 or plug. The patch is made of tissue from the heart 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. A bandage will be placed over the area.
After the operation, your child will be taken to the intensive care unit (ICU) for observation.
2 to 4 hours
Pain and swelling are common in the first 1 to 2 weeks. Medicine and home care can manage pain.
The usual length of stay is 5 to 7 days. If your child has any problems, he or she may need to stay longer.
Right after the procedure, the staff may:
During your child's stay, the staff will take steps to lower the chance of infection such as:
There are also steps you can take to lower your child's chances of infection such as:
It will take about 6 weeks to fully heal. Physical activity will need to be limited during recovery. Your child may need to delay return to school.
Call the doctor if your child is not getting better or has:
Call for medical help or go to the emergency room right away if your child has:
If you think your child is having an emergency, call for medical help 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. Accessed November 3, 2020.
Atrial septal defect. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/medical/heart/asd.html. Accessed November 3, 2020.
Atrial septal defects. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/atrial-septal-defects. Accessed November 3, 2020.
Geva T, Martins JD, et al. Atrial septal defects. Lancet. 2014 May 31;383(9932):1921-1932.
Open-heart surgery. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/heart-encyclopedia/treat/surg/open.htm. Accessed November 3, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Kari Kassir, MD Last Updated: 5/7/2021