Such holes in the heart are usually not apparent on examination and an echocardiogram or MRI is usually needed to make a diagnosis. Symptoms include breathlessness and palpitations (awareness of abnormal heart beats). The risk of stroke is also higher than normal.
The device used for an ASD closure is like a large pad of extremely high quality and costly wire wool, which has a special property that allows it to return to its manufactured shape and size, after it has been pulled out into a narrow shape within the delivery catheter. The procedure is usually performed under general anaesthetic, and even so many patients are treated as a day case.
The device is placed through 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 then opened on the other side of the hole. The central part of the device is what 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. A six month course of aspirin and clopidogrel is prescribed.
Dr. Shapiro has performed approximately 800 ASD Closures since 1992 and it is comforting to know, that the audit data shows no deaths or serious complications have occured.
This figure shows the second of two ASD devices being placed.
Who needs ASD closure?
Almost all significant sized ASD need to be closed. The decision is made by a committee of specialist MDT (Multi Disciplinary Team).