Atrial Septal Defect Treatment

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No one wants to be told their child has a hole in their heart. It’s terrifying no matter when it happens. Whether you’ve been told after a fetal echo, or a doctor detected a murmur during a routine sports physical, no one feels prepared. The good news is that these holes, (sometimes called septal defects), including atrial septal defects (ASD), can be fixed.

At UVA Health Children’s, we have experience in treating ASDs using a full range of options.

Our team of congenital heart defect experts creates an individualized plan of care for your child. And with our resources, we can even provide options like minimally invasive ASD repair. This means a quicker and easier recovery.

Atrial Septal Defect Treatment at UVA Health Children’s

If we suspect your child has an ASD, we’ll first listen to their heart. We’ll then perform an ultrasound of the heart, called an echocardiogram, to look at the ASD. On the ultrasound, we’ll be able to evaluate the ASD’s size. We can also talk through whether or not it should be treated, based on your child’s other health concerns.

The imaging also shows us where the opening is within the heart. Knowing the location is important for picking the right kind of ASD repair.

How Is an ASD Closed?

There are several ways to close an atrial septal defect. At UVA Health Children’s, we offer the full spectrum of care.

What option is right for your child depends on:

  • Where the hole is located
  • The size of it

Observation: Small ASDs may close on their own. If there are no other conditions, your doctor may suggest watchful waiting. Some ASDs never fully close, but also don’t cause problems. For these, checking in with your doctor and getting routine scans may be enough.

Transcatheter occlusion: This minimally invasive procedure is performed in our cardiac catheterization lab. This is our preferred method since it doesn’t require open heart surgery. Using a catheter, a long hollow tube, a small device is put in place to block the hole. Because it blocks, or "occludes" the hole, the device is often referred to as an occlusion device.

Surgery: When ASDs are very large, occur along with other heart problems, or are in an unusual location, sometimes we have to perform open heart surgery. It's scary to hear your baby needs open heart surgery, but our heart surgeons are among the best in the country. Once repaired, your baby will need a little longer to recover. But afterwards, they'll have the same benefits as kids whose ASDs were closed using other methods. 

What Is an Atrial Septal Defect?

An ASD, or atrial septal defect, is a hole between the top two chambers of the heart, the atria. An ASD can cause the right side of the heart to have to work too hard. This can create a chain of problems, including:

  • Enlarged heart
  • Pulmonary hypertension
  • Stroke
  • Excessive blood flow to the lungs

Sometimes, ASDs don’t cause any symptoms. Many people with an ASD don’t find out until later in life. That’s because, unlike many other congenital heart defects, ASDs are often symptom-less.

For babies in the NICU, an ASD can be associated with added difficulty breathing. In these instances, we strongly recommend the minimally invasive ASD closure. In addition to treating patients within our own NICU, our POLeR team also takes infants from surrounding NICUs for this procedure.

Types of Atrial Septal Defects

Depending on where it occurs, an ASD may be called:

  • Secundum atrial septal defect: The most common form of ASD. Occurs in the middle of the atrial septum.
  • Primum atrial septal defect: Occurs in the lower part of the atrial septum. Sometimes occurs with other CHDs.
  • Sinus venosus atrial septal defect: This rare defect occurs in the upper or lower part of the wall separating the heart chambers. It’s usually seen with other large heart changes.
  • Coronary sinus atrial septal defect: Occurs when part of the wall between the hearts vein and the left atrium is missing.

ASDs can also be classified by their relative size. Some ASDs are so small they don’t affect the children at all. But others are large enough they need to be closed much earlier in life. In general, only the secundum type atrial septal defect can safely be closed with the minimally invasive 

Helicopter from UVA Health Children's that can transport infants with ASD defects.

POLeR for Atrial Septal Defects

If your baby is in a neighboring NICU and an ASD is found, we can help transfer your baby for POLeR, a minimally invasive ASD closure technique. Our newborn emergency transport service (NETS) can safely bring your child to UVA Health Children's. Whether by ground or by air, your child will receive medical support during travel. 

Learn More About Minimally Invasive ASD Closure

Atrial Septal Defect FAQs

If your child has an ASD, you will have a lot of questions. Ask your doctor questions about your child’s specific case. Below are some of the most frequent questions we hear:

What caused my child’s ASD?

We don’t really know. Many times, there are no risk factors and a child develops an ASD anyway. Sometimes, all of the risk factors are present, and a baby is born with a perfectly healthy heart.

Genetics is a risk factor. If you have a family history of congenital heart defects, you may want to consult with our genetics team before getting pregnant. You can also get a fetal echo to take a look at your baby’s heart before birth.

When embryos are exposed to any of the following during pregnancy, they can also be at increased risk for ASDs:

  • Some medications, including antiseizure medications
  • Rubella (German Measles) exposure
  • Smoking or alcohol use

How does a transcatheter occlusion device stay in place?

As soon as the occlusion device is placed, the flow of blood across the hole is stopped.  Overtime, the natural tissue of the heart grows over the device to seal it in place.

Can my child have a normal life afterwards?

With a repair, your child should be able to live a normal life. It will be an important part of their medical history though. Their regular doctor should be able to listen for it on exams.

Through life, we recommend regular visits with a cardiologist, especially before heart-intensive events, like pregnancy or starting a new sport.