KEY-HOLE METHOD OF CLOSING HOLE IN THE HEART

A hole in the heart is commonly a congenital defect (meaning- one is usually born with this problem) but can remain silent till adulthood.

If the hole is between the two top chambers of the heart (called Atria) it is called an Atrial Septal Defect or ASD.

The same between the two bottom chambers of the heart (the right and left ventricles) is called Ventricular Septal defect or VSD.

When the same connection happens outside the heart, between the main artery that comes out of the left side of the heart called Aorta and the artery that comes out of the right side of the hearty called the pulmonary artery- it is called a Patent Ductus Arteriosus (PDA).

A septal defect is open communication between the atria/ventricles via a defect in the septum that separates the two top and two bottom chambers of the heart.

The pressure difference between the two chambers and the amount of shunt flow depends upon the size of the defect and the relative distensibility of the right and left ventricles.

Shunting across a defect varies during the phases of the cardiac cycle

The right-sided volume overload from such a defect is usually well tolerated for years until the patient develops very high pressure in the lungs called pulmonary hypertension and/or weakness of one or both ventricles.

The development of pulmonary hypertension is highly variable and depends not only on the size and duration of the shunt but on a number of individual factors.

Most patients with a defect with significant shunt flow (ie, pulmonary to systemic flow more than 2:1) will be symptomatic (with atrial arrhythmias, exercise intolerance, fatigue, dyspnea, and heart failure) and require closure by the age of 40.

However, some patients do not become symptomatic until 60 years of age or older.

The complications of leaving a hole unattended are a progressive failure of function of the heart leading to heart failure and paradoxical embolism where a small clot in the vein (which is common) can go across the hole to the left side of the heart and cause a stroke etc.

Early closure of defects will ensure that these complications do not develop and therefore it will be advisable to seek expert opinion early.

In the past, closure of such holes necessitated open-heart surgery but recent advances in keyhole surgery have made it possible to close most of these holes by a small keyhole procedure by inserting a catheter in the vein in the leg.

Below, you will see full description and examples of the closure of such holes.

Please feel free to contact me if you need any further information about this treatment.