Treatment of Atrial Septal Defect (ASD)

Dr. Gaurav Agrawal January 23, 2022

There is no role of medicines in closing or treating the atrial septal defects (ASD). Only ostium secundum (OS-ASD) with “good rims” around the defect can be closed in cath lab by putting an umbrella device (angiographically, without open heart surgery) or else has to be closed by surgery. Ostium primum type of atrial septal defect can be closed or treated only by open heart surgery. Sinus venosus defect (SVC type) primarily is treated by open heart surgery in children. In adults, in selected cases, it can be treated by putting a covered stent angiographically without open heart surgery. Sinus venosus defect (IVC type) is treated by open heart surgery only. Ideal age of closure for primum type of defect is between 2-3 years of age, for sinus venosus defect (SVC/IVC type) is around 5 years of age. Ostium secundum defect (OS-ASD) is generally closed between 2-4 years of age. How we close OS-ASD (ostium secundum type) by using an umbrella device?

Majority of OS-ASD can be closed in cardiac cath lab (angiographically) without open heart surgery in a beating heart.

Procedure is generally done under conscious sedation (& sometimes in general anesthesia).

Patient can be discharged on next day and can perform daily activities without any fear. Within six months, device becomes a part of heart for life long.

This method of closure of ASDs does not produce scar on the chest. Patient needs to take antiplatelet medicines (blood thinner) for 6 months post-procedure.

Dr. Gaurav Agrawal

Dr Gaurav Agrawal is a Pediatric Cardiologist (Child and Fetal heart Specialist). Dr Agrawal is a pediatrician who has specialized training in the treatment of various child heart related problems (neonates to 18 years of age). He is also having a vast experience in fetal echocardiography.

He is one of the very few pediatricians in India who practices pediatric cardiology exclusively. Cardiac problems in children are common in children, sometimes life threating and often not diagnosed properly. Early diagnosis and timely treatment is very important. Areas of specific interest include child echocardiography including fetal echocardiography, diagnostic and therapeutic cardiac catheterization (pediatric cardiac holes closure by device, opening of obstructed cardiac valves by balloons etc).

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