I have developed special expertise in the diagnosis
and treatment of structural heart disease.

Procedures - Atrial septal defect (ASD) closure

 

I have performed approximately 500 cases since 1992 The audit data shows no deaths or serious complications includes device displacement. Such holes are usually not apparent on examination and an echocardiogram is usually needed to make a diagnosis. (see figure below). Symptoms include breathlessness and palpitations (awareness of abnormal heart beats). The risk of stroke is also higher than normal and there is potentially an association with migraine (see below).

 

The device used is like a large pad of extremely expensive wire wool which has the special property to return to its manufactured shape and size after it has been pulled out into a narrow shape in the delivery catheter. The procedure is usually performed under general anaesthetic but many patients are treated as a day case. The device is placed from the vein in the groin . A 2-3mm tube is passed from the vein through the hole in the heart to the left atrium, the device is then opened partly in this chamber and drawn slowly and carefully to the septum (tissue around the hole) . It will lodge there and the second portion of the device is opened on the other side of the hole. The central part of the device then blocks off the hole. Because of the nature of the metal used the device forms a tight disc shape . There is little in the way of post-operative pain and there is a prompt return to normal activities. Often a six month course of aspirin and clopidogrel is prescribed.

 

This figure shows the second of two ASD devices being placed.

 

See also:
www.amplatzer.com
www.clevelandclinic.org
www.cardiosource.com

 

Who needs ASD closure?
Almost all significant sized ASD need to be closed.

 

enquiries@lmshapiro.com