Atrial Septal Defect (ASD) Surgery
An Atrial Septal Defect (ASD), commonly known as a hole in the heart is a congenital heart defect, usually present in infants since birth. When there is a hole in the upper chamber of the heart, an atrial septal defect surgery is required to treat this problem. Though this condition is present from birth, small defects might close automatically during infancy or early childhood. However, the large and long-lasting defects can cause damage to the patient’s heart and lungs, making it imperative to treat it at the right time. For adults living without the diagnosis of ASD since decades, there are higher chances of heart failure or high blood pressure which can ultimately affect the arteries in the lung.
For many babies born with ASD, there might not be any visible signs or symptoms. By the age of 30, symptoms may start showing in some adults while for many others, symptoms don’t occur until decades later. If the ASD does not close on time, the resultant excess blood flow can pose serious threats to the heart and overall health. Some common indications include:
- Failure of the right side of the heart – Since the right side tends to overwork and compensate for the defect while pumping more blood to the lungs, it might tire itself and stop functioning eventually.
- Irregular Heartbeats (Arrhythmia) – Since extra blood flows to the right upper chamber, it might lead to the enlargement and stretching of the atrium over time, leading to arrhythmia.
- Stroke – Sometimes, the lungs might filter out blood clots, which then travel to the heart. If these travel from the right chamber to the left due to ASD and then the clot gets pumped into the body, there is a higher chance of a stroke.
- Pulmonary Hypertension – Patients experiencing high blood pressure in the pulmonary arteries might need to see a doctor immediately.
- Other symptoms – Shortness of breath, difficulty in breathing, respiratory infections or feeling the heartbeat or a murmur in the heart may be signs of trouble.
It is best to visit a cardiac surgeon at the earliest if you notice any of these symptoms so that you can get an atrial septal defect treatment without any further delay.
Your surgeon will do a thorough body check-up and review all your test reports to ensure you are fit for the ASD surgery. Make sure to follow all the instructions given by your doctor and take all the medications prescribed before the day of the surgery. Some of the common tests include:
- Blood Test
- Chest X-Ray
- Imaging Studies
An ASD repair is performed by a senior experienced cardiac surgeon and his team under general anaesthesia. There are two common techniques to perform this surgery and the surgeon will choose the right one based on your diagnosis.
- Transcatheter Procedure – The surgeon will insert a thin flexible tube, known as a catheter in your body through the groin. Using echocardiography (sound waves to create moving heart images) and angiography (using dye and x-rays to highlight the coronary arteries), the surgeon is able to successfully guide the tube to the heart. Once it reaches its destination, it then blocks the hole and the catheter is withdrawn.
- Open Heart Surgery – The doctor will suggest an open heart surgery to treat primum ASD (hole in the lower part of the atrial septum) and sinus venosus ASD (hole in the upper part of the atrial septum). The surgeon makes an incision in the chest to reach the heart effectively. Then, a special patch is used to properly block the hole in the heart. During this procedure, a heart-lung machine is used to support the patient.
After an ASD heart surgery, recovery is comparatively faster and smoother. The patient is transferred to a normal room from the ICU within a day or two. The morning after the surgery, the doctor will remove the drainage tubes. The pacing wires are then removed after one or two days. If the doctor notices an irregular heartbeat, the pacing wires may be kept for a longer time. Patients can go home after 3-4 days but need to take extra care and precautions to maintain their heart health. Most doctors advise patients to avoid the consumption of aspirin for 6 months after the surgery to control the formation of blood clots.
Patients must ensure that they don’t injure their chest in any way so that the incision can heal properly. Normally, movements at home must be monitored for a few days post-surgery to ensure a safer recovery.
RISK AND COMPLICATIONS
Usually, an atrial septal defect repair is done successfully without much complications or risk factors involved. Depending on when the defect was diagnosed, the patient’s future health can be determined. Children tend to live long and healthy lives post the surgery and become completely normal within a year or two. However, some possible complications after the surgery might include:
- A sudden heart failure or stroke
- Infection in the wound
- Heart infection, also known as endocarditis
- Excessive Bleeding