What is an ASD?

Atrial septal defects (ASD) are one of the commonest types of congenital heart defects. The defect is simply a hole between the left and right upper chambers (atria) of the heart. Although an ASD is frequently detected in childhood, it is not unusual for the defect to be found well into adulthood. A smaller variant of an ASD termed a PFO (patent foramen ovale) may be found in up to 18% of the population and can be associated with strokes.

What are the Symptoms?

An ASD allows blood to move from the left side of the heart to the right side of the heart. This can cause enlargement of the heart chambers, elevation in the blood pressure of the lungs (pulmonary hypertension), irregular heart rhythyms and stroke. The turblulent flow across an ASD can also predispose to infection within the heart (endocarditis).

How is an ASD treated?

Small ASD's (also termed PFO's) can sometimes be treated with life-long blood thinners, although this is quite controversial. In children and small adults an umbrella device can be placed percutaneously through the groin to close the hole, however, only very limited defects are amenable to this approach.

The mainstay of therapy remains direct surgical closure. In the past, a sternal splitting incision had been the standard approach to this rather simple operation. Through the development of minimally invasive techniques the operation can be performed through a 4 cm incision in the side. Furthermore, the development of Robotics has allowed surgeons to perform the operation through pinhole incisions in the side, avoiding the need for a midline sternal incision.

Cardiothoracic surgeons at St. Luke's- Roosevelt Hospital were pioneers in the development of these procedures. At the Center for Minimally Invasive Cardiothoracic Surgery, we have experts in all approaches to ASD treatment (medical, interventional, surgical). Information regarding the treatment of ASD can be obtained at 212-523-2717.

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