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Treatments and drugs
By Mayo Clinic staffIf your child has an atrial septal defect, your doctor may recommend monitoring it for a period of time to see if it closes on its own, while treating any symptoms with medications. Many atrial septal defects close on their own during childhood. For those that don't close, some small atrial septal defects don't cause any problems and may not require any treatment. But many persistent atrial septal defects eventually require surgery to be corrected.
If your child needs treatment, the timing of it depends on your child's condition and whether your child has any other congenital heart defects.
Medications
Medications won't repair the hole, but they may be used to reduce some of the signs and symptoms that can accompany an atrial septal defect. Drugs may also be used to reduce the risk of complications after surgery. Medications may include those to:
- Keep the heartbeat regular. Examples include beta blockers (Lopressor, Inderal) and digoxin (Lanoxin).
- Reduce the risk of blood clots. Anticoagulants, often called blood thinners, can help reduce the chances of developing a blood clot and having a stroke. Anticoagulants include warfarin (Coumadin) and anti-platelet agents, such as aspirin.
Surgery
Many doctors recommend repairing an atrial septal defect diagnosed during childhood to prevent complications as an adult. For adults and children, surgery involves plugging or patching the abnormal opening between the atria. Doctors can do this through two methods:
- Cardiac catheterization. A thin tube (catheter) is inserted into a blood vessel in the groin and guided to the heart. Through the catheter, a mesh patch or plug is put into place to close the hole. The heart tissue grows around the mesh, permanently sealing the hole.
- Open-heart surgery. This type of surgery is done under general anesthesia and requires the use of a heart-lung machine. Through an incision in the chest, surgeons use patches or stitches to close the hole.
Medical monitoring
Follow-up care depends on the type of defect and whether other defects are present. For simple atrial septal defects closed during childhood, only occasional follow-up care is needed. For adults, follow-up care may depend on any resulting complications.
- What are holes in the heart? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/holes/. Accessed Oct. 26, 2011.
- Facts about atrial septal defect. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/heartdefects/AtrialSeptalDefect.html. Accessed Oct. 26, 2011.
- Cohen S, et al. Atrial septal defect. In: Ferri FF. Ferri's Clinical Advisor 2012: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05611-3..C2009-0-38601-8--TOP&isbn=978-0-323-05611-3&uniqId=291436269-101. Accessed Oct. 26, 2011.
- Bernstein D. Acyanotic congenital heart disease: The left-to-right shunt lesions. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed Oct. 26, 2011.
- Vick GW, et al. Management and outcome of isolated atrial septal defects in children. http://www.uptodate.com/home/index.html. Accessed Oct. 26, 2011.
- Atrial septal defect. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/pediatrics/congenital_cardiovascular_anomalies/atrial_septal_defect_asd.html. Accessed Oct. 26, 2011.
- Wiegers SE, et al. Management of atrial septal defects in adults. http://www.uptodate.com/home/index.html. Accessed Oct. 26, 2011.
- Wiegers SE, et al. Pathophysiology and clinical features of atrial septal defects in adults. http://www.uptodate.com/home/index.html. Accessed Oct. 26, 2011.
- Birth defects. March of Dimes. http://www.marchofdimes.com/baby/birthdefects_congenitalheart.html. Accessed Oct. 26, 2011.
- Questions and answers on the 2010 dietary guidelines advisory committee report. U.S. Department of Agriculture. http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2010/DGAC/Report/QandA-DGACReport.pdf. Accessed Oct. 26, 2011.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 8, 2011.
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