What is ASD device closure?
An atrial septal defect is a hole in the wall between the two upper chambers of the heart. Device closure is a way of sealing that hole without opening the chest.
A small, self-expanding implant — folded down to fit inside a catheter no wider than a drinking straw — is guided from a vein in the groin up into the heart. Once it is in the right place it opens out on both sides of the hole, like a tiny double-sided umbrella clamping the wall between them. Over the following months the child's own tissue grows over the device, and the hole is permanently closed.
Which ASDs can be closed this way
The most common type — a secundum ASD, sitting in the middle of the wall — is usually suitable, provided the hole has enough firm rim around its edges for the device to grip and it is not too large.
Other types, including primum defects, sinus venosus defects and unroofed coronary sinus, sit in positions where a device cannot anchor safely. Those need surgical repair, and we will tell you clearly if that is your child's situation.
Closure is recommended when the hole is significant enough to be overloading the right side of the heart and the lungs — not simply because a hole exists. Some small ASDs close on their own and need nothing but observation.
What happens on the day
Your child is admitted in the morning and is asleep under general anaesthesia throughout. A catheter is passed from the groin vein into the heart. The defect is measured precisely, usually with the help of transesophageal echo. The correctly sized device is positioned, checked from several angles, and only then released.
The procedure typically takes one to two hours. There is no cut in the chest and no stitches — just a small puncture in the groin.
Recovery
Most children are up and eating within a few hours and go home the next day. There will be no scar on the chest. Normal school and gentle activity usually resume within a week; contact sports are restricted for a period we will specify.
Your child will take a blood-thinning medicine, usually aspirin, for around six months while the device becomes covered by the body's own tissue. Follow-up echos are done at set intervals to confirm the device is sitting well and the hole is sealed.
Device closure compared with surgery
| Device Closure | Surgical Closure | |
|---|---|---|
| Access | Puncture in the groin | Incision in the chest |
| Bypass machine | Not needed | Required |
| Typical hospital stay | 1 day | 5–7 days |
| Scar | None on the chest | Permanent chest scar |
| Return to school | About a week | Several weeks |
| Suitable for | Most secundum ASDs with adequate rims | All ASD types, including those unsuitable for a device |