Atrial Septal Defect Closure: How to Perform the Interventional Procedure Effectively
Atrial Septal Defect (ASD) closure through interventional means is a widely accepted and effective treatment for patients who meet specific criteria. This minimally invasive procedure is not suitable for everyone, but for those who qualify, it offers a faster recovery time and reduced risk compared to open-heart surgery.
Who Is a Good Candidate for ASD Intervention?
Successful interventional closure of an atrial septal defect depends on the patient's anatomical characteristics. Ideal candidates typically meet the following conditions:
The diameter of the ASD should be less than 36 millimeters.
There should be at least 5 millimeters of rim or edge around the defect to provide sufficient support for the closure device.
The overall size of the defect must be larger than the device used to seal it, ensuring a secure fit and effective closure.
Step-by-Step Overview of the Procedure
The interventional ASD closure is usually performed using a catheter-based approach. The process begins with a puncture in the femoral vein, not the femoral artery as previously described, through which a thin, flexible catheter is inserted. This method is less invasive and allows for a quicker recovery.
Once access is established, a guidewire is carefully guided through the catheter and into the heart, specifically targeting the site of the atrial septal defect. Using real-time imaging techniques such as echocardiography or fluoroscopy, the physician ensures precise placement of the closure device.
Deployment of the Closure Device
Once the guidewire is in position, the closure device—often a self-expanding, umbrella-like metal mesh (commonly referred to as an occluder)—is delivered through the catheter and deployed at the defect site. The device is designed to conform to the shape of the defect and gradually integrate into the heart tissue, permanently sealing the hole.
Why Is This Procedure Considered Advanced?
Currently, interventional ASD closure is considered a mature and well-established procedure. It eliminates the need for open-heart surgery in many patients, significantly reducing hospital stays and recovery time. Moreover, the success rate is high, and complications are relatively rare when performed by experienced cardiologists in a well-equipped facility.