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Atrial Septal Defect


Overview

Atrial septal defect (ASD) is a hole in the wall between the two upper chambers of the heart, called the atria. This hole usually does not cause any symptoms or problems in a young child. Over a person’s lifetime, the extra blood crossing the hole goes to the lungs. This can damage the blood vessels of the lungs. Adults who still have a hole are at greater risk of strokes. If very small, an atrial septal defect may not require any treatment. Other defects may need cardiac catheterization or surgery to close or patch the hole.


Normal heart – in a healthy heart with proper blood flow, the blue droplets representing oxygen-poor blood travel to the lungs, and the red oxygen-rich droplets circulate through the body.

A heart with ASD has a hole in the wall between the two upper chambers of the heart. Over the course of a lifetime, extra blood can pass through to the lungs and potentially damge the lung's blood vessels.

A secundum defect is in the center of the wall.

Primum defect – located low in the wall, down near the tricuspid and mitral valves.



Treatments

When required, atrial septal defects (ASD) are repaired using cardiac catheterization or surgery. The animated videos below show blood flow in a heart with atrial septal defect (ASD) and indicate how a heart with ASD is treated.


Heart with ASD

Cardiac catheterization treatment for ASD – many atrial septal defects can be closed through a one-day procedure in the cardiac catheterization laboratory. An Inova pediatric interventional cardiologist guides a catheter to the heart and places a device across the hole to close it. Some atrial septal defects cannot be closed in the catheterization lab because of:

  • Size (too big)
  • Not enough heart tissue to attach the closing device to
  • Compression on the coronary arteries or valves

Suture closure for secundum defect – one of the surgical options is to open the chest in the center and stitch the hole closed using sutures. Surgery includes:

  • General anesthesia
  • Using cardiopulmonary bypass
  • Locating and closing the hole

Surgery for ASD – some patients may be candidates for minimally invasive surgery while others will need surgery to open the chest in the center and patch the hole. Surgery includes:

  • General anesthesia
  • Using cardiopulmonary bypass
  • Locating and closing the hole