Let's learn about cardiac closure devices.

When the doctor tells you or your child that they have a "hole in the heart," you may feel very scared. It's normal for questions like "What do I do now? Will I have to have a major operation?" to come to mind. But don't worry. Today, medical science has advanced a lot. Instead of having to open the chest like in the past, it is possible to close such holes in a very simple way. Today, we are going to talk about a special device used for this, a Cardiac Closure Device.

What is this "hole in the heart"? (ASD and PFO)

Simply put, our heart has four main chambers. The two upper chambers are called the atria. There is a wall-like part between these two right and left atria. This is called the interatrial septum. It is because of a hole in this wall that we usually call a "hole in the heart."

There are mainly two types of these conditions:

1. Atrial Septal Defect (ASD): This is essentially a "hole in the heart." A hole is present in this wall at birth. Blood flows back and forth between the two chambers of the heart through this hole.

2. Patent Foramen Ovale (PFO): This is not really a real hole like an ASD. Think about it, when we are in our mother's womb, there is a small opening in the wall between these atria. It is essential at that time. After we are born, this opening closes on its own. But in some people, it doesn't close properly. It remains like a small flap. That's what is called a PFO.

These holes sometimes close on their own, or they can become small enough to live with without any problems. However, some people may need to have these holes closed if they experience symptoms such as difficulty breathing, frequent fatigue, or an abnormal heart rate .

Why do you need to close this hole?

To understand this, you need to know a little about how the heart works. The left side of our heart carries "good" blood that is full of oxygen and needs to be sent to the body. The right side carries "bad" blood that is low in oxygen and needs to be cleaned from the body.

Now imagine what would happen if there was a hole between these two sides? Yes, some oxygenated blood and some deoxygenated blood would mix together. Then the cells in our body wouldn't get the right amount of oxygen. That's why we get tired and have trouble breathing.

How do you insert this device into the heart?

In the past, this could only be done through open-heart surgery, which involves opening the chest. But that's not the case anymore. Today, more than 80% of ASDs are closed using a simple procedure called cardiac catheterization.

The way this is done is very amazing.

• First, a thin tube (catheter) is inserted into a large blood vessel in your leg, near your groin.
• Then, using X-ray-like technology, the doctor carefully guides the tube close to the hole in the heart.
• The closure device is carried inside this tube. This device is like two small umbrellas connected together.
• When you get close to the hole, as soon as you pull it out of the tube, one side of this device opens on one side of the hole, and the other side on the other side, completely closing the hole like a button.

These devices come in various sizes, from 4 to 40 millimeters. Your doctor will choose the device that best fits the size of the hole in your heart.

The benefits and possible side effects of this method

As with any medical treatment, there are benefits as well as very minor risks.

What do you do to prevent side effects?

Doctors do various things to minimize these risks.

• Prevent blood clots: You will be given anticoagulants for the first 6 months after the device is inserted.
• To prevent the device from interfering with other treatments: The new devices are designed so that if another heart treatment is needed in the future, the catheter can be passed through the same device.
• Choosing the right size: The key to preventing erosion of the heart wall is to choose the right size device for each patient.

Things you can do for your safety

To protect yourself from endocarditis, an infection that can occur, especially during dental treatments, you should take care of these things during the first 6 months.

• Tell every doctor and dentist you see that you have this device. It's a good idea to carry a card with that information.
• If you develop symptoms of infection such as fever, body aches, or sore throat, call your doctor immediately.
• Take great care of your teeth and gum health. Brush your teeth daily and see a dentist regularly.
• Before doing anything that could cause bleeding, such as a tooth extraction or cleaning, ask your doctor to confirm whether you need to take antibiotics.

How long does it take to heal and other facts

With this catheter method, you only have to stay in the hospital for one night after the device is inserted. After that, you will have to avoid strenuous activities for about two weeks. But you can return to normal activities in a day or two. The recovery time is much shorter than with open surgery.

This device is made by attaching a polyester fabric to a wire frame made of a nickel-titanium alloy (Nitinol). Over time, our own body's own tissue grows around this device, becoming part of the heart itself.

Some people may not be able to do this catheter method. In such cases, surgery is required. But now there is technology to perform that surgery with as small an incision as possible (minimally invasive).

You should talk to your doctor about whether you can have an MRI scan after having this device inserted. Some devices are safe for MRI, but there may be some limitations.

Hole in the heart, ASD, PFO, Cardiac Closure Device, Heart disease, Cardiac catheterization, Atrial Septal Defect