Many atrial septal defects close by themselves in childhood. For those who do not close in childhood, some small atrial septal defects may not need treatment. However, many persistent atrial septal defects eventually require surgery.
If you or your child have an atrial septal defect, the cardiologist may recommend watching it for some time to see if it closes on its own. Your doctor will decide when you or your child will need treatment, depending on your condition and whether you or your child has other congenital heart defects.
Drug therapy does not help heal the hole, but it can be used to reduce some of the signs and symptoms that may accompany an atrial septal defect. You can also use medications to reduce the risk of complications after surgery. Medications can include those that maintain a regular heartbeat (beta blockers, antiarrhythmic drugs) or reduce the risk of blood clots (anticoagulants, antiplatelet agents).
Many doctors recommend correcting a medium or large atrial septal defect diagnosed in childhood or adulthood to prevent future complications. However, surgery is not recommended if you have severe pulmonary hypertension, because it can worsen the condition.
For adults and children, the operation involves suturing or applying an occluder to the pathological opening between the Atria. Doctors will evaluate your condition and determine which of the two procedures to use:
- Endovascular treatment. Doctors insert a thin flexible tube (catheter) into a blood vessel in the groin area and direct it to the heart using imaging techniques. Through the catheter, doctors place an occluder – this is two umbrellas made of intertwined threads — an alloy of Nickel and titanium, connected by a jumper, in which a special patch is located to close the hole. Heart tissue grows around the mesh, permanently closing the hole.
This type of procedure is used to eliminate only “secondary” atrial septal defects. However, some large secondary atrial septal defects may require open heart surgery.
- The open-heart surgery. This type of surgery is performed under General anaesthesia and requires the use of a circulatory machine. Through an incision in the chest, surgeons close the hole with a patch. This procedure is the only way to correct atrial defects: primary, venous and coronary sinuses.
This procedure can be performed using small incisions (minimally invasive surgery) and with robotic technology for certain types of atrial septal defects.