Atrial Septal Defect (ASD) Closure (Treat Opening Between the Upper Heart Chambers)

· Those in Mexicali, Mexico for 3 days or more.
· Those with children who have Atrial Septal Defect (ASD).
· Those who have ASD and show symptoms like difficulty breathing, increased fatigue and others.
· Those who want to get ASD Closure surgery after other treatment methods have not succeeded.
· Those who want their children to have an active and healthy lifestyle in the future.

Every child is born with an opening between the upper heart chambers. This normal fetal opening allows blood to detour away from lungs before birth. After birth, this opening would usually close or narrow within several weeks or months since it is no longer needed. Atrial Septal Defect (ASD) is a condition where the opening between the upper heart chambers do not close. In most cases, the causes are unknown. Some children can have other heart defects along with ASD.

There are also those who get diagnosed and/or treated with ASD during adulthood. If symptoms like fatigue, difficulty breathing, stroke, atrial fibrillation, or if the right ventricle becomes enlarged, repair may be considered.

· Secundum: Most common type of ASD, occurs in the middle of the wall between the atria (atrial septum).

· Primum: Defect occurs in the lower part of the atrial septum and might occur with other congenital heart problems.

· Sinus venosus: A rare defect, usually occurs in the upper part of the atrial septum and is often associated with other congenital heart problems.

· Coronary sinus: Also a rare defect, where part of the wall between the coronary sinus (part of the vein system of the heart) and the left atrium is missing.

ASD treatments depend on the patient’s age and the condition of the defect (size, location, severity). Very small ASDs usually may not need any treatment, but follow-up visits for observation will be conducted.

When the ASD has not closed on its own, then cardiac catheterization or heart surgery may be recommended to fix the hole.

It’s important to understand that a large ASD can cause extra blood to overfill the lungs and overwork the right side of the heart. If not treated, the right side of the heart eventually enlarges and weakens.

1. A transesophageal echocardiogram (TEE) will be started so that the surgeon could look at the heart during surgery.
2. Incision will be made in the breastbone to reach the heart.
3. The patient will be put on a cardiopulmonary bypass machine which pumps blood to the body while the heart is stopped temporarily.
4. Incision will be made in the heart’s right atrium to get access to the defect.
5. A patch will be stitched onto the hole in the septum to close it.
6. Heart will be closed with sutures and the cardiopulmonary bypass machine will be removed.
7. Pacing wires will be placed temporarily on the heart to prevent heart rhythm abnormalities. Chest tubes will also be placed to collect residual blood or fluid in the chest after the operation.
8. Skin will be sutured or stapled.
9. End of surgery.

<Advantages>
· Safe procedure
· A chance at giving your child an active lifestyle
· Improves appetite
· Better health of the heart
· Excellent long-term outcomes

<Limitations>
· Risks associated with surgery

<Preoperative Details>
· For pediatrics patients, the child's immunization record should be prepared
· Patients should also be free from infections, including dental infections, for up to 6 weeks prior to surgery
· Inform any sensitivity or allergy to any medicines, latex, tape, and anesthesia medicines (local and general)

<Postoperative Details>
· After surgery, patients may be taken to the intensive care unit and monitored
· Patients may be on a breathing tube or a respirator for first few hours after surgery

Q1: What activities can my child do?
A1: During recovery, the surgeon may advise some activity changes for a short time. But after successful healing, there are no restrictions and the child may be able to participate in normal activities. Sometimes medicines to prevent blood clots and infection should be taken for a few months after ASD closure.

Q2: What will my child need in the future?
A2: Depending on the type of ASD, your child's pediatric cardiologist may examine your child periodically for monitoring. Usually, no additional surgery or catheterization are needed after the procedure.

Q3: If I had surgery to close an ASD in childhood, what can I expect?
A3: The prognosis after ASD closure during childhood is excellent and late complications are uncommon. Most women with ASD can also go through pregnancy. However, those with larger defect and have other complications should consult with a doctor before becoming pregnant.

Q4: What is the outlook for adults who get treated for ASD?
A4: With early diagnosis and repair, the outcome is excellent. However, there is an associated risk of developing atrial arrhythmia due to scars at the closure area. In rare cases, re-operation may be needed if a leak occurs at the closure area. Each patient should get a consultation with the doctor regarding the best treatment and risks according to their condition.

Q5: Can ASDs be left untreated?
A5: Small ASDs that do not affect heart function do not not require treatment, but it's important to see the doctor regularly to make sure it has not worsen in any way. But for serious cases of ASDs, leaving them untreated can make the heart and lungs work harder and less efficiently. This will lead to a greater risk of developing other heart, lung, and blood problems.

[Clinic Name] Hospital de la Familia
[Location] Mexicali, Mexico
[Nearest Stations / Attractions] The hospital is about 17 mins drive from Mexicali International Airport and 10 mins drive from Holiday Inn Express & Suites Mexicali
[Clinic Opening Time] Monday to Sunday (24 hrs)