Pediatric Heart Expert Forum
Is it must to close an ASD
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Is it must to close an ASD

My daughter has a moderate sized ASD (5 to 8mm) with some degree of volume loading and raised pulmonary artery pressure. Right now she is at 2.7 years of age. All the doctors I have gone through told “its better to have device closure for it after a certain time”. My question is, if I don’t do any surgery or device closure, what could be the worst possible incident/s that may happen to my baby. I need to know the severity of this cause. Can you please help me out?
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Dear Mzaman,

A secundum atrial septal defect (ASD), which is a hole in the wall between the upper two heart chambers, typically causes no symptoms at this age.  However, over the years, it can cause an increased risk of pulmonary hypertension (high blood pressure across the lungs) as well as heart arrhythmias.  Therefore, we typically look to close moderate and large defects some time between ages 2 and 5 years, or so.  This depends on several factors, including if the patient has symptoms, how large the patient is, and how large the defect is.  Although I cannot say for sure in your daughter, the likelihood of spontaneous closure of a defect this size is low.  Therefore, it would probably be a good idea to prepare to move forward for this.  The good news is that the majority of these can now be closed with placement of a device by catheter without needing open-heart surgery.  Not all of them can be closed that way, so make sure that she is managed by a center with good experience in caring for this defect.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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Marie M Gleason, M.D.Blank
The Children’s Hospital of Philadelphia
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