Congenital heart defect may require surgical repair in adulthood
Some people are born with a hole in the septum (muscle wall) that divides the left and right sides of the heart. A hole in the upper part of the septum that divides the two upper chambers (atria) is called an atrial septal defect, or ASD. This condition often heals on its own in childhood, or it may be repaired early on in life. In some cases, the defect may not be identified until adulthood. If left untreated, the abnormal flow of blood back and forth between the left and right atria affects the flow of oxygen-rich blood to other parts of the body. Conditions such as arrhythmia, pulmonary hypertension, and heart failure can develop.
Surgical treatment for atrial septal defect
The type of surgical approach for atrial septal defect repair depends on the size of the hole. If the hole is small, then minimally invasive surgery may be an option. With this approach, the surgeon is able to access the heart through a small incision (cut) on the right side of the chest in between the ribs. Tiny instruments are guided into the area, allowing the surgeon to sew the hole.
For a larger hole, open-chest surgery may be preferred as the surgeon needs greater visibility and access to the heart in order to take a “patch” from the pericardium, the lining of the heart, in order to repair the hole.
For both minimally invasive atrial septal defect repair and open-chest surgical repair, a heart-lung bypass machine is required. This performs the work of the heart and lungs, allowing the blood to continue pumping through the body while the heart is temporarily stopped for the surgical repair.