A selected group of patient with an abnormal hole in the heart wall between the two pumping chambers can have this defect closed with a procedure similar to a cardiac catheterisation.
The defects that can be treated in the this manner are:
- Atrial septal defect (ASD) This is a hole found between the two upper chambers of the heart, the right and left atrium.
- Ventricular septal defect (VSD) This is a hole found between the two lower chambers of the heart, the right and left ventricle.
- Patent ductus arteriousus (PDA) This is a defect caused when the ductus arteriousus fails to close. This is how you received blood while in the womb. This normally closes in the first few days of life.
This procedure is similar to a heart catheterisation. Briefly a flexible long tube (or catheter) is inserted into the veins and arteries in the groin. This catheter is moved up into the heart with the aid of x-ray screening. Dye is injected to determine the size of the chambers also the size of the defect and position are also assessed. Using a balloon catheter of a known diameter the defect is then measured. In comparison to the balloon sizing a device appropriate to that particular patient can be chosen. The devices used are called amplatzer they are made from a wire mesh which is self expanding. The device is then advanced into the heart through an introducer sheath (larger less flexible tube)
Half of the device used is connected to one side of the atrial septum and the second half is attached to the other portion forming a sandwich effect.
The entire procedure is completed under general aesthetic. The position of the device after implantation will be assessed using transoesphageal echo.
All patients are commenced on aspirin for 6 months and clopidgel for 6-12 weeks post insertion of the device. This is to reduce the risk of clot formation which is a rare complication of this procedure. Within a three month period your heart cells will have grown over the device.
After the test bed rest is requested for 4–6 hours. The puncture site will be examined several times after the procedure to check for bruising or possible bleeding. On discharge you will need a responsible person to be with you for the next 24 hours. The site where the catheter was inserted may be tender for a few days. Most people get back to normal activity after a day or two but this varies from one person to another.