When do you need an ASD surgery?

You’ll need an ASD closure surgery if you experience the following symptoms-

• Shortness of breath
• Fatigue
• Swelling of legs, feet or abdomen
• Heart palpitations
• Irregular heart rhythm
• Stroke
• Heart murmur

How do you prepare for ASD surgery?

• Your doctor may provide specific instructions prior to your ASD repair procedure and discuss risks such as bleeding, infection, or adverse reaction to anesthesia.
• You will be assessed by  your anesthesiologist before the surgery to review their medical history. 
• You will be asked to avoid eating and drinking after midnight before the surgery.
• You may be asked to stop taking certain medicines before your surgery, usually blood-thinning medicines like warfarin or aspirin.

• You will be asked to undergo routine tests for assessing your health before surgery. These may include:

1. Chest X-ray
2. Electrocardiogram (ECG)
3. Blood tests
4. Echocardiogram (to assess your current valve)
5. Coronary angiogram (to assess blood flow in your heart arteries

What happens during ASD repair surgery?

As the surgery begins, a cardiologist starts a transesophageal echocardiogram (TEE) so the surgeon can look at the heart structure during surgery.

The surgeon then makes an incision in the breastbone to reach your heart, and you’ll be placed on a cardiopulmonary bypass machine – which pumps blood to the body, bypassing the heart and lungs except for the coronary arteries – while your heart is stopped temporarily. An incision is then made in your heart’s right atrium to access the defect.

The patch – either your own pericardial tissue or a synthetic graft – is then stitched onto the hole in the septum to close it.

The heart is closed with sutures, and the cardiopulmonary bypass machine is removed. Pacing wires are placed temporarily on the heart to prevent heart rhythm abnormalities after the operation. Chest tubes are placed to collect residual blood or fluid in the chest after the surgery, and the skin is closed with stitches or staples.

What happens post ASD repair surgery?

• After surgery, you’ll be shifted to the intensive care unit and monitored continuously 

• You’ll be on a respirator and have a breathing tube for a few hours, post surgery

What are the potential risk factors of ASD repair surgery? 

It's not exactly known why atrial septal defects occur, but congenital heart defects run in families and sometimes occur with other genetic problems. Some ASD conditions that you have or that may occur during pregnancy may increase your risk of having a baby with a heart defect, including:

• Rubella infection
• Drug, tobacco or alcohol use
• Diabetes or lupus
• Obesity
• Phenylketonuria (PKU)

A small atrial septal defect will ideally never cause any problems. Small atrial septal defects often close during infancy. However, larger defects can cause some serious problems, including:

• Right-sided heart failure
• Arrhythmias
• Increased risk of a stroke
• Shortened life span

Less common serious complications post ASD surgery may include:

• Pulmonary hypertension
• Eisenmenger syndrome

Lifestyle changes:

• You’ll be asked to take Vitamin K every day. Vitamin K is found in green leafy vegetables and other foods.
• It may take 6 to 8 weeks after surgery before you feel completely better. You’ll be asked to avoid lifting heavy objects
• You’ll be given customized plans that integrate proper nutrition and exercise

Key Terminologies:

Transesophageal echocardiogram:A transesophageal echocardiogram (TEE) is a special type of echocardiogram. It is usually done when your doctor wants to look more closely at your heart to see if it could be producing blood clots.

Eisenmenger syndrome:   Eisenmenger's syndrome (or ES, Eisenmenger's reaction, Eisenmenger physiology, or tardive cyanosis) is defined as a process in which a long-standing left-to-right cardiac shunt caused by a congenital heart defect (typically by a ventricular septal defect, atrial septal defect, or less commonly, patent ductus arteriosus) causes pulmonary hypertension.