Atrial septal defect is a congenital heart defect, meaning a defect present at birth. A hole between the atria, the upper chambers of the heart, allows blood from the left atrium to flow into the right side of the heart and to the lungs. The increased blood flow into the lungs and right side of the heart taxes them and can damage the tissues. Atrial septal defects are the third most common type of heart defect, comprising around 7 percent of all congenital heart defects, the Cleveland Clinic reports. Treatment depends on the size of the defect.
Medications
Medications can be given to prevent complications and reduce symptoms both before and after surgery to close the defect, if necessary. Medications to keep the heartbeat regular include digoxin and beta blockers, MayoClinic.com states. Blood thinners, such as warfarin or aspirin, may be given to prevent clots from forming in the atria that could break off and travel to other parts of the body such as the lungs and brain. Blood clots can cause stroke or pulmonary embolism, both potentially life-threatening complications. Anticoagulants taken for at least the first six months after surgery prevent clot formation, the Cleveland Clinic explains. Antibiotics help prevent infection for the first six months after surgery, but have no proven benefit beyond that point, according to the American Heart Association.
Percutaneous Repair
One way to patch a large ASD is in conjunction with cardiac catheterization, a procedure whereby a catheter is threaded into the heart through a large blood vessel. A mesh patch or plug is placed inside the catheter. The catheter is advanced into the heart to the area near the defect under the guidance of X-ray and intracardiac echocardiogram. The mesh is slowly pushed out of the catheter to cover the defect, blocking the hole. Heart tissue then grows around the plug.
Open Heart Surgery
Open heart surgery is a much more invasive type of surgical repair of ASD. Open heart surgery may be necessary if the defect is large, or if there are other heart defects that need repair at the same time. Open heart surgery is done under general anesthesia and requires use of a heart-lung bypass machine during surgery. A chest incision allows access to the heart. The defect is repaired using a piece of the patient's pericardium, the lining of the heart, if possible, the Cleveland Clinic states. Some defects can be sewn together without a patch.
