Let's learn everything about Atrial Septal Defect - ASD Closure in a simple way.

It's normal for any mother or father to get worried when a doctor says, "The baby has a hole in his heart." Hearing these words brings up a lot of thoughts. But if you really understand it, it's nothing to be afraid of. Today we're talking about the treatment for closing a hole in the heart that many people have heard of but don't really know about, called ASD Closure. Let's talk about this very simply, in a way that you can understand.

First, let's see, what is this hole in the heart (ASD)?

Okay, to put it simply, this is a congenital hole in the wall (called the 'septum') between the two upper chambers of our heart (which we call the 'atria'). Medically, we call this condition (Atrial Septal Defect) , or (ASD) for short.

Now you might think this is a disease. The amazing thing is, we are all born with this small hole in our heart. It is normal. Usually, this hole closes on its own within a few weeks or months after the baby is born. But sometimes, some children have a slightly larger hole that may not close on its own. That is when the problems start to arise.

Why do you need to close this hole?

If the hole is small, it may not cause a big problem. Maybe no treatment is needed. But if this (ASD) is large, it can cause a lot of problems.

Imagine, when there is a large hole between the two upper chambers of the heart, the blood in one chamber leaks into the other. It's like a hole between two water tanks. This causes the heart and lungs to work harder than they normally do. When this happens over time, various complications can occur.

See the table below for the main problems that can arise from this.

It is because of these risks that your doctor may suggest an ASD Closure, a surgery to close this hole. This surgery is usually performed on young children to prevent this potential damage in the future.

How is this surgery done? There are two methods!

There are two main methods for closing a hole in the heart. One is open-heart surgery , which involves making an incision in the chest. The other is a minimally invasive procedure , which involves inserting a small tube through the groin.

Your cardiologist will decide which method is right for you or your child. This will depend on several factors:

• The size of the hole and where it is located in the heart.
• Other heart conditions you have.
• Your overall health.

Let's now look at these two methods separately.

1. Open Heart Surgery (Surgical ASD Closure)

This is the traditional method. In this, you are completely anesthetized, meaning you are so deeply asleep that you don't feel anything.

• During the surgery: You will be connected to a special machine (heart-lung machine) to temporarily do the work of your heart and lungs. Then, the surgeon will make a small incision in the middle or right side of your chest to reach your heart. Then, a small tube with a camera (endoscope) will be used to find the exact location of the hole.
• How to close the hole: There are several ways to close the hole.
• It is covered with a patch made of synthetic material.
• Or you can cover it with a piece of tissue taken from another part of your own heart.
• It may be closed with sutures .

Although this is a major surgery, it can be done very successfully and safely with today's technology.

2. Transcatheter ASD Closure

This is the new and preferred method by many people. Because it does not involve a large incision in the chest. Therefore, the healing time is very short. However, this method can only be done if the hole is small and located in the right place in the heart.

• How it's done: You won't be fully anesthetized, but you'll be given medication to help you sleep. Then, the doctor makes a small incision in a large vein in your groin (femoral vein) and inserts a thin tube called a catheter through it.
• Device to the heart: At the end of this tube is a small device (closure device) that closes the hole. The doctor carefully guides this tube through the vein to the heart while looking at technologies such as X-ray and echocardiogram.
• Closing the hole: Once the hole is in the heart, the small device opens like an umbrella and closes the hole. Then the doctor takes out the catheter. That's it!

What happens after the surgery? How is the recovery time?

The healing time will vary depending on the procedure you had.

• If you had open surgery , you will need to stay in the hospital for a few days. After you go home, you will need to avoid strenuous activity for a few weeks.
• If you had a catheter procedure , you can usually go home in a day or two and resume your normal activities within a week.

For the first 6 months after surgery, you will need to take medication to stop your blood from clotting. Also, if you are having dental work, your doctor will likely recommend antibiotics to prevent infection.

The most important thing is to go to the clinic every day that the doctor says to come (follow-up appointments) . Then we can check whether the hole is closed properly and whether the heart is working well.

Are there any risks? When should you see a doctor immediately?

As with any surgery, there are some risks involved. These are very rare, but it's good to be aware of them.

• Allergies to the materials used in the surgery.
• Irregular heartbeat (Arrhythmia).
• Bleeding.
• Infection.
• Kidney damage.
• Stroke or transient ischemic attack.

Don't worry about these things. Your medical team is doing their best to prevent these things from happening.

However, if you experience any of the symptoms below when you go home after surgery, you should go to the hospital or call your doctor immediately.

What will life be like after the surgery?

This is the best part. Research has shown that if someone under the age of 25 has this surgery, their life expectancy is the same as someone who never had ASD. That means you can live a completely healthy, normal life .

The important thing is that closing the hole allows you to live a longer, healthier life than having an (ASD) without treatment.

So, if the doctor says that you or your child has ASD, don't worry about it. Talk to your doctor about it. He or she will help you choose the treatment that is best for you.