Atrial Septal Defect Repair

Medically reviewed by Drugs.com. Last updated on Jul 7, 2024.

• Care notes
• Ambulatory
• Discharge
• Español

AMBULATORY CARE:

What you need to know about an atrial septal defect (ASD) repair:

An ASD repair is used to close a hole in the septum (wall) between the upper chambers of your heart. The upper chambers are called the right atrium and the left atrium. An ASD repair can be done through open heart surgery or a percutaneous (through the skin) procedure. The type of repair used depends on the size of the ASD and your symptoms.

Prepare for an ASD repair:

• You may need blood tests, a chest x-ray, an EKG, or an echocardiogram. The tests will help your provider plan for your surgery or procedure. You may be able to donate your own blood. A family member or a friend with the same blood type as you may be able to donate blood for you.
• Your provider may tell you not to eat or drink anything after midnight on the day of your surgery or procedure. Your provider will tell you which medicines to take or not take. You will be given an antibiotic through your IV on the day of surgery or procedure. This will help prevent a bacterial infection. Tell the healthcare provider about any allergies you have, including to antibiotics or anesthesia.
• Your provider may ask you to take blood thinners if you are having a procedure instead of surgery. Your provider may ask you to start this medicine a few days before your procedure. You may instead be given a blood thinner through your IV on the day of your procedure. This will help prevent blood clots.

What will happen during a surgical ASD repair:

• You will be given general anesthesia to keep you asleep and free from pain during surgery. An IV may be placed in your wrist to monitor your blood pressure. A second IV may be placed in a large vein in your chest or neck to monitor pressures in your heart. Your surgeon will make an incision in your chest. Your surgeon will cut or spread your ribcage apart to reach your heart. Your heart may be connected to a bypass machine. This machine pumps blood to your body and keeps blood out of your heart during surgery.
• Your surgeon will make an incision in your heart. Your surgeon will close the ASD with stitches or a patch. The bypass machine will be stopped and blood will flow through your heart again. The incision will be closed with stitches. Your surgeon may place 1 or more drains in your chest to remove air, blood, or fluid. A bandage will be placed over the area.

What will happen during an ASD repair procedure:

• You may be given general anesthesia to keep you asleep and free from pain during the procedure. You may instead be given medicine to help you relax during the procedure. You will be awake with this medicine, but you should not feel pain during the procedure.
• Your provider will insert a catheter into a vein in your groin. Your provider may use x-ray pictures to help guide the catheter to your heart. Your provider will also use an echocardiogram to look at your heart during the procedure. Your provider will insert a closure device into the ASD with the catheter. Your provider will check to make sure the device is placed correctly and the ASD is closed. Your provider will then remove the catheter and place a bandage over the incision.

What to expect after an ASD repair:

• Healthcare providers will monitor your blood pressure, heartbeat, oxygen levels, and breathing. They will check your bandage for bleeding or swelling. Do not get out of bed until healthcare providers say it is okay. You may need blood tests, chest x-rays, an EKG, or an echocardiogram before you leave the hospital. These tests will make sure the ASD is closed and your heart is working correctly.
• It may take you several weeks to recover from surgery. During this time you may need someone to help you with laundry, cooking, and activities of daily living (ADLs). ADLs include bathing, dressing, and grooming. Talk to your provider if you do not have someone to help you at home. Healthcare providers may be able to come to your home and help you with ADLs. You may not be able to drive for several weeks. You may want to arrange for someone to drive you to appointments and errands during this time.

Risks of an ASD:

You may get an infection or bleed more than expected. Your heartbeat may become irregular or you may have heart failure. Your heart muscle or valves may be damaged during surgery. Fluid may collect around your heart or lungs and make it hard for you to breathe. You may get a blood clot in your leg, arm, heart, lungs, or brain. These problems can be life-threatening. The devices used to close the ASD may move out of place. You may need another surgery to fix this. Depending on the damage that your ASD has caused, your heart problems may not get better after repair.

Call your local emergency number (911 in the US) if:

• You have any of the following signs of a heart attack:
  • Squeezing, pressure, or pain in your chest
  • You may also have any of the following:
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Shortness of breath
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat
• You have any of the following signs of a stroke:
  • Numbness or drooping on one side of your face
  • Weakness in an arm or leg
  • Confusion or difficulty speaking
  • Dizziness, a severe headache, or vision loss
• You feel lightheaded, short of breath, and have chest pain.
• You cough up blood.
• You have trouble breathing.

Seek care immediately if:

• Blood soaks through your bandage.
• Your stitches come apart.
• Your heart is beating faster or slower than usual.
• Your arm or leg is larger than usual, painful, and warm.
• You stop urinating or urinate less than usual.
• You have swelling in your ankles or feet.

Call your cardiologist or surgeon if:

• You have a fever or chills.
• Your pain does not get better even after you take your pain medicine.
• Your wound is red, swollen, or draining pus.
• You have nausea or are vomiting.
• Your skin is itchy, swollen, or you have a rash.
• You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

• Heart medicine helps strengthen and control your heartbeat. You may also need medicine to lower your blood pressure.
• Diuretics help remove extra fluid from your body.
• Antibiotics help prevent a bacterial infection.
• Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
• Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
• Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. Many types of blood thinners are available. Your healthcare provider will give you specific instructions for the type you are given. The following are general safety guidelines to follow while you are taking a blood thinner:
  • Watch for bleeding and bruising. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
  • Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
  • Do not start or stop any other medicines or supplements unless your healthcare provider tells you to. Many medicines and supplements cannot be used with blood thinners.
  • Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.

Care for your incision site as directed:

• Ask your provider when you can remove the bandage and bathe. Your incision site may look bruised or swollen. The bruising and swelling should get better in a few days. Carefully wash around the incision site with soap and water. It is okay to let soap and water run over the site. Do not scrub your incision site. Gently pat the area dry and put on a new, clean bandage as directed.
• Change your bandage if it gets wet or dirty. Do not put powders or lotions on your incision site unless your provider says it is okay. Do not swim or take a bath until your provider says it is okay. This will help prevent an infection. Check your incision site every day for signs of infection, such as redness, swelling, or pus.

Weigh yourself daily as directed:

Weigh yourself in the morning before breakfast. Weight gain can be a sign of extra fluid in your lungs or body. Extra fluid can make your heart work harder and can cause health problems.

Prevent infection:

• Wash your hands often. Use a germ-killing hand gel if soap and water are not available.
• Stay away from others who are sick. Tell family and friends not to visit if they are sick. Ask all visitors to wash their hands when they visit. Do not go to crowded places such as the mall or movie theater. Ask your provider how long you need to follow these directions.
• Ask your provider if you need antibiotics before procedures. Some procedures may allow bacteria to get into your blood and travel to your heart. This can cause an infection in your heart and prevent you from healing. You may need antibiotics before certain procedures that happen in the next 6 months to prevent infection. This may also include certain dental procedures. Ask your provider for more information.
• Ask your provider about vaccines. You may need to wait 2 to 3 months to get vaccines.
  • Get a flu vaccine as soon as recommended each year, usually starting in September or October.
  • A pneumonia vaccine is recommended for all adults 65 or older. Your provider may also recommend this vaccine if you are younger than 65.
  • Get a COVID-19 vaccine as directed. At least 1 dose of an updated vaccine is recommended for everyone 6 months or older. COVID-19 vaccines are given as a shot in 1 to 3 doses, depending on the age of the person who receives it. COVID-19 vaccines are updated throughout the year. Your healthcare provider can help you schedule all needed doses as updated vaccines become available.

Self-care:

• Rest as directed. Do not lift anything heavier than 5 pounds or do vigorous activities. Do not drive until your provider says it is okay. These actions will put too much stress on your incision. Ask your provider which activities are safe for you to do. Also ask when you can return to your normal activities and work or school.
• Eat heart healthy foods. You may need to eat foods that are low in salt, fat, or cholesterol. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask your provider for more information about a heart healthy diet.
• Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause heart and lung damage. Ask your provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your provider before you use these products.
• Limit or do not drink alcohol. Ask your cardiologist if it is okay for you to drink alcohol. Alcohol can increase your risk for high blood pressure, diabetes, and coronary artery disease.
• Maintain a healthy weight. Ask your provider what a healthy weight is for you. Extra weight can increase the stress on your heart. Ask your provider to help you create a weight loss plan, if needed.
• Exercise as directed after you recover. Your provider can help you create an exercise plan that is right for you. Exercise will help keep your heart healthy.

Follow up with your cardiologist or surgeon as directed:

You will need to return for tests. These tests will make sure your heart is working correctly. Write down your questions so you remember to ask them during your visits.

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