Atrial septal defect

What is an atrial septal defect?

Atrial septal defect, or ASD, is a congenital (present-at-birth) condition that affects the tissue between the right and left upper chamber of the heart, called the inter-atrial septum. ASD is a defect (hole) in the inter-atrial septum that typically allows blood to go from the left to right chambers and can lead to symptoms and reduced heart function.

Roughly one out of every 120 babies are born with some type of heart defect, and ASD is the most common. Some ASDs close on their own and require no treatment, while other ASDs will need to be closed.

When treatment is needed, the cardiovascular specialists at the UF Health Cardiovascular Center can help. Our specialists, all faculty members of the University of Florida College of Medicine – Jacksonville, are experienced in treating and managing this condition with minimally invasive, catheter-based options.

Atrial septal defect: Symptoms

In many people born with ASD, the defect may close on its own and or is too small and doesn't cause symptoms that require treatment. However, symptoms may occur at almost any age, and can include:

• Difficulty exercising or other physical activity
• Frequent lung infections
• Heart murmur
• Heart palpitations
• Shortness of breath
• Stroke
• Swelling in the legs, feet or abdomen

Atrial septal defect: Diagnosis

If your heart specialist at UF Health Jacksonville suspects you may have ASD, one or more of the following tests may be ordered to aid in diagnosis:

• Cardiac catheterization to assess congenital heart defects, measure the pressures inside your heart and check the heart arteries.
• Chest X-ray to check your heart and lungs to help rule out other conditions that could be causing your symptoms.
• Computed tomography (CT) scan to capture and analyze detailed images of your heart using X-ray.
• Echocardiogram to obtain detailed images of your heart to check the valves and look for heart defects.
• Electrocardiogram to check the electrical activity of your heart for potential rhythm problems related with the ASD.
• Magnetic resonance imaging (MRI) to capture and analyze 3D images of your heart to check for structural or functional problem.

Atrial septal defect: Treatment

In many cases, an ASD closes on its own or is too small to cause symptoms and no treatment is required. However, if symptoms develop or there is evidence of reduced heart function or heart chamber enlargement, closure of the ASD is required. The majority of people with the most common type of ASD (ostium secundum) are treated with catheter-based closure, while surgery is only recommended for very large ASDs or other uncommon ASD types.

• Percutaneous ASD closure is a minimally invasive catheter-based procedure that may not require general anesthesia. The procedure is performed via the femoral vein in the groin through a small puncture incision on the skin. The catheter system, a thin flexible tube, is inserted in the groin, advanced into the heart and placed in the left upper chamber through the ASD hole. A two-disc device is inserted through the catheter and used to close the hole in the heart by placing one disc on each side of the hole. After the device is implanted, the surgeon removes the catheter and then closes the small incision site. The heart tissue will then grow around the device, which permanently seals the hole.
• Open-heart surgery may be necessary in some cases. You'll be put under general anesthesia for this procedure. Your surgeon will make an incision on your chest and use a patch to close the hole. Depending on the type of ASD you have, the surgeon may be able to close your hole using minimally invasive surgery with small incisions.

Why choose UF Health Jacksonville?

The internationally recognized heart team experts at the UF Health Cardiovascular Center Jacksonville are at the forefront in cardiac care, research and education. For more than two decades, our doctors have been leaders in percutaneous transcatheter interventions and minimally invasive heart and chest surgery. Our interventional cardiologists and cardiothoracic surgeons are professors and researchers in one of the nation's largest cardiovascular training programs at the University of Florida College of Medicine – Jacksonville.

Our cardiologists, as faculty of the University of Florida Division of Cardiology – Jacksonville, participate in numerous national and international clinical trials. Using the most sophisticated equipment available, the center offers state-of-the-art diagnostic, therapeutic and rehabilitative cardiac services. In Northeast Florida, many cutting-edge interventional therapies and numerous treatment options are available only at the UF Health Cardiovascular Center – Jacksonville, which we believe results in the best possible outcomes for our cardiovascular patients.