Many small- to moderate-sized ASDs can close on their own over time. However, if an ASD has not closed by 5 years of age, it’s unlikely that it will close by itself. In this case, closure of the ASD by catheter-based devices or open-heart surgery may be necessary.
- Closing the ASD with a closure device – Closing the ASD with an implanted closure device is a treatment that helps avoid open-heart surgery. An angiogram/cardiac catheterization is performed in the hospital’s cardiac catheterization laboratory, which involves threading a catheter through a vein into the heart; then delivering the closure device through the catheter to the ASD; and closing the opening. Patients who undergo this procedure typically may go home the same day or soon thereafter. Transcatheter closure of an ASD is the most commonly used approach.
- Surgical closure of the ASD – Open-heart surgery may be recommended if the ASD is too large for treatment with a catheter-based device. During surgery, the surgeon opens the heart and closes the defect by using a patch or sutures. The length of stay in the hospital after this surgery may be from three to five days.
Follow-up care into adulthood
Following closure of an ASD, whether with surgery or with a closure device, patients need to follow up with their cardiologist on a regular basis. The exact frequency of follow-up depends on several issues unique to each patient. In general, however, these patients will need follow-up of some sort for the rest of their lives, usually yearly early on and then every three to five years thereafter.