Atrial septal defect
ASD is a hole between the atria.
ASD closure device
The device is an alloy of flexible metals (nickel and titanium). It contains a PTFE (Teflon) coating to make it waterproof.
ASD closure
The device is implanted between the two atria to close the ASD.
Why are you being offered an ASD closure?
An atrial septal defect (ASD) is a hole in the wall separating the two atria of the heart that is present during the embryonic stage and does not close after birth. Depending on the size of the ASD, it can cause exertional discomfort from a young age or may not present until adulthood, past the age of thirty. Additionally, it can lead to a stroke, a neurological complication that necessitates closure to prevent recurrence.
Based on your medical evaluation, you may be offered a right heart catheterization beforehand to determine the indication for ASD closure.
Can I eat and drink before this test?
You must be more than 12 hours before the exam. We try to respect the order and time of passage according to the organization of the day. However, depending on the emergencies of the day, the duration of the interventions of the day, it is possible to have a waiting time of several hours.
Performing the closing gesture:
Your test will take place in the interventional cardiology unit.
When you are admitted to the cardiology department, you will be asked to put on a hospital gown. You will need to remove all jewelry, underwear and socks.
A small area of your groin will be shaved which will be the entrance route for the examination.
A stretcher-bearer will take you to the catheterization room in your bed. You will be helped onto a narrow, hard table. It will be a little cold in the room. Around you, you will see X-ray machines and monitors. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring machine. Your body will be covered with a large sterile drape. General anesthesia will begin.
The procedure involves implanting a device comprising two metal mesh discs connected by a small connector and positioned on either side of the septum between the two atria to make it watertight. This flexible device is implanted by cardiac catheterization via a puncture of the femoral vein.
This procedure is performed with ultrasound guidance (usually via transthoracic or transesophageal route), requiring general anesthesia or simple sedation.
You will be asked to lie down for a few hours after the procedure.
You will generally be discharged the day after the procedure after a transthoracic ultrasound scan.
What are the expected benefits?
Closing the ASD will balance the volumes between the heart chambers and reduce the dilation of the heart and therefore eliminate discomfort during exercise.
What are the risks involved?
Despite the experience of the operators and the significant technical progress concerning catheters and devices, this is an invasive procedure involving risks:
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allergic complications most often linked to the use of anesthesia products.
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Vascular complications at the femoral puncture site: the most common is a hematoma which results in a bluish appearance usually without consequence and disappearing after a few days. Rarely (<1% of cases), a vascular injury may require surgical repair or transfusion.
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cardiovascular complications during the hospital period : they are very rare (<0.5% of cases) of stroke, hemorrhagic effusion around the heart or displacement of the device, which may require additional intervention, sometimes surgical.
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Cardiac complications after hospital discharge : the most common complication is the occurrence of palpitations linked to a rhythm disorder (<5% of cases): generally early (first weeks) and transient, this arrhythmia may require an action or additional treatment if it persists. Much more rarely (<0.5% of cases), the formation of clots on the device or a displacement of the device may occur.
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complications leading to death : they are very exceptional (<0.1%).
What follow-up after the device implantation?
The implantation of the device requires taking a double antiplatelet treatment for a period of three to six months.
No special physical or professional precautions are necessary after implantation of the device. This device also does not contraindicate any future exploration or intervention.
Antibacterial prophylaxis will be offered in the event of risky extracardiac procedures during the 6 months following implantation of the device.
Atrial septal defect closure
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