Atrial septal defect
The 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.
What is an atrial septal defect closure?
An atrial septal defect (ASD) is a hole in the septum separating the two atria of the heart that is present at the embryonic stage and does not close after birth. Depending on the size of the ASD, it can cause discomfort during exercise from a young age or only appear in adulthood after the age of thirty. It can also cause a stroke, a neurological complication that requires its closure to prevent a recurrence.
In children, the indication for closure is made when the weight has reached 20 - 25 kilos to limit complications related to the device that is too large.
ASD Closure procedure:
The child must fast for 12 hours before the examination. The ASD is closed in the catheterization room. The child is laid flat and given general anesthesia so as not to move during the procedure and to allow the transesophageal ultrasound. The doctor performs a venipuncture in the groin and inserts a thin catheter. The catheter is guided to the heart. The device is positioned through the interatrial septum. At the end of the procedure, the groin is compressed for about ten minutes and then a pressure bandage is applied. The child is monitored in the recovery room until he or she is fully conscious and then returned to the parents. Food is only allowed two hours after the end of the procedure to avoid the risk of aspiration. Discharge is generally the next day after an ultrasound check.
What are the expected benefits?
Closing the CIA 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 devices, 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 prosthesis. 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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