Atrial Septal Defect | Symptoms & Causes
What are the symptoms of an ASD?
Most children who have an ASD do not experience symptoms until school age. But symptoms can be present as soon as after birth in children who are born prematurely or in children who have other CHDs, such as mitral valve disease.
Often, children who have an ASD are referred to a cardiologist because their pediatrician detected a heart murmur while listening to their heart. If your child does have symptoms, they can include:
- Rapid breathing
- Decreased endurance
- Slow weight gain and growth
- Frequent respiratory infections
Atrial Septal Defect | Diagnosis & Treatments
How is an atrial septal defect diagnosed?
Although a pediatrician can detect an ASD by hearing a heart murmur, sometimes the condition is not diagnosed for many years. Depending on the type of heart murmur your doctor hears, they may recommend one or more or the following tests for your child:
- Echocardiogram (cardiac ultrasound)
- Electrocardiogram (ECG)
What are the treatment options for ASD?
If your child’s ASD is large or causing circulation problems or poor health, your family will probably be advised to consider closing the ASD through treatment. Our team of specialists at Boston Children’s Benderson Family Heart Center will aim to treat your child with the least possible invasive procedure.
Cardiac catheterization
Most of the time ASDs can be safely closed with cardiac catheterization. If your child has this nonsurgical procedure, a long thin tube (a catheter) that leads a small umbrella-shaped closure device will be inserted through their leg vein. The catheter will guide the closure device to their heart, where the device will open to cover the ASD with a patch.
Your child should feel little-to-no discomfort during the procedure; they are given deep sedation or general anesthesia. They typically go home the day of the catheterization.
Surgical approaches
If catheterization cannot close your child’s ASD, open-heart surgery will be recommended to place a patch over the hole. Most hospitals repair an ASD with a sternotomy; surgeons access the heart through the sternum (breastbone). The procedure leaves a visible scar on the upper chest and the sternum will have to be wired together to help the bone heal. Sometimes the thymus gland has to be removed to give surgeons a complete view of the heart. Recovery in the hospital after a sternotomy can last four to five days, and it can take three months for the sternum to heal.
At Boston Children’s, we also offer two minimally invasive cardiac surgery approaches that avoid certain aspects of a sternotomy:
Thoracotomy
Boston Children’s is one of just a few pediatric hospitals to offer this approach. Our surgeons will make an incision under the armpit, keeping your child’s sternum intact and leaving a relatively smaller incision scar. The thymus also doesn’t need to be removed. Your child will experience less pain than they would after a sternotomy, and their recovery time in the hospital will be shorter: two to four days. With an accelerated recovery, they’ll be able to resume physical activities and contact sports as soon as possible after surgery.
Mini-sternotomy
If your child is not eligible for a thoracotomy, they might be able to avoid a full sternotomy if they are a candidate for a mini-sternotomy. This approach requires a smaller chest incision and only a partial splitting of the sternum, either the upper or lower portion. It leaves a small scar on the chest, but it also can be potentially less painful after surgery and allow a child to recover faster.
Watch our webinar: Minimally invasive approach to ASD repair
Using advanced surgical techniques, Boston Children’s offers multiple treatment options for ASD, including a minimally invasive thoracotomy approach. In this webinar, we discuss what ASD is, when it can be closed in the catheterization lab, and the different surgical options available.
Supporting your family through recovery and beyond
Our specialists have extensive experience treating atrial septal defects and will review all treatment options with your family. No matter what your decision is, your family will have all the time and resources you need to think it over, and we are always available to answer any questions.
Working with the Enhanced Recovery After Cardiac Surgery (or ERAS Cardiac) Program, our team will always focus on maximizing safety, minimizing pain, and shortening your child’s length of stay at the hospital and their overall recovery. And once your child is home, our team will continue to follow their progress and heart health into adulthood.
