POLeR: Minimally Invasive Heart Defect Closure

Learning your child has a heart problem, like an atrial septal defect (ASD) or a patent ductus arteriosus (PDA), is terrifying. Not only can these lesions make the child’s heart work harder, but they can also cause problems with breathing, eating, and circulation.

Medicine and surgery used to be the only options for PDA and ASD treatment, but a minimally invasive procedure provided by the UVA POLeR (Percutaneous Occlusion of Left to Right shunts) team offers better outcomes with fewer risks.

Fixing a septal defect doesn’t need to be scary. Whether your baby has a patent ductus arteriosus or an atrial septal defect, UVA Health Children’s has the resources to repair it safely.

POLeR Treatment at UVA Health Children’s

Many babies are transported from other NICUs to UVA Health Children’s to undergo treatment by the POLeR team. Before transfer, doctors at your home hospital have already shared information with the POLeR team, who evaluated and agreed your child would be expected to benefit from closure of their ASD or PDA. After transfer, we will repeat a physical examination, echocardiogram and labs, to make a final assessment before any intervention.

Typically 1-2 days after arrival, your baby will be taken to the cardiac catheterization laboratory and sedated. If they do not already have a breathing tube in place, one will be placed to stabilize their airway and breathing. One of our experienced cardiac catheterization doctors will use a needle to thread a small hollow tube (catheter) into a blood vessel. Once the catheter reaches the ASD or PDA, a device is placed to close the hole.

If there are no complications, your child will then stay in our NICU for 1-2 days of observation. After that, they'll be transferred to their home NICU.

Possible Benefits of Closing a PDA or ASD

• Improves heart function
• Decreases respiratory support needs
• Doesn’t involve surgery
• Short procedure
• High success rate
• Shorter average NICU stays
• Less chance of complications

Possible Complications of Closing a PDA or ASD

• Blood vessel injury requiring anti-clotting medication
• Narrowing of the lung (pulmonary) artery or body (aorta) artery due to the device
• Device movement (embolization)
• Unsuccessful procedure

Why You Shouldn’t Wait for POLeR

If your child has a septal defect, it can lead to a longer NICU stay. It can also delay important developmental milestones, like taking food orally.

Closing the PDA or ASD often makes it easier for your baby to breathe and eat. That means less respiratory support and leads to babies having a shorter NICU stay. Having less respiratory support reduces the chance of complications. Complications from long-term respiratory support include worsening lung disease or retinopathy of prematurity.

While medicine is usually the first choice, there are many times when it doesn’t work. Though heart surgery can successfully close a PDA or ASD as well, they are much riskier in small, premature babies, and could extend recovery time.