Expert Surgical Intervention for Heart Defects
UT Southwestern’s cardiothoracic surgeons are experts at performing open-heart
surgery to correct an atrial septal
defect (ASD), which is a hole in the heart’s septum. Our surgery group is one of the nation’s leading programs, with more than
600 open-heart surgery procedures each year.
UT Southwestern is also home to a dedicated Cardiac
Rehabilitation Program. Cardiac rehabilitation is a critical component of recovery and
can prevent future heart disease.
What to Expect
ASD Closure: Preoperative Details
The surgeon provides specific instructions to the patient prior to the ASD
closure procedure, discussing risks such as bleeding, infection, or adverse
reaction to anesthesia.
Patients also meet with the anesthesiologist prior to the surgery to review
their medical history. Patients should not eat after midnight the night before
the surgery.
On the day of surgery, the patient arrives at the hospital, registers, and
changes into a hospital gown. A nurse reviews the patient’s charts to make sure
there are no problems.
The anesthesiologist then starts an IV, and the patient is taken to the
operating room, where the surgeon verifies the patient’s name and procedure
before any medication is given. Surgery will begin once the patient is under
anesthesia.
For pediatric patients: It's important that children are free from infection –
including dental infections – for up to six weeks prior to surgery. Please be
sure that your child's immunization records are made available to your surgeon
or the nurse.
ASD Closure:
Operative Details
Before
the surgery begins, a cardiologist starts a
transesophageal
echocardiogram (TEE) so the surgeon can look at the heart structure during surgery.
The surgeon then makes an incision in the breastbone to reach the heart,
and the patient is placed on a cardiopulmonary bypass machine – which pumps
blood to the body, bypassing the heart and lungs except for the coronary
arteries – while the heart is stopped temporarily. An incision is then made in
the heart’s right atrium to access the defect.
The patch – either the patient’s own pericardial tissue or a synthetic
graft – is then stitched onto the hole in the septum to close it.
The heart is closed with sutures, and the cardiopulmonary bypass machine is
removed. Pacing wires are placed temporarily on the heart to prevent heart
rhythm abnormalities after the operation. Chest tubes are placed to collect
residual blood or fluid in the chest after the surgery, and the skin is closed
with stitches or staples.
ASD Closure: Postoperative
Details
After
surgery, patients are taken to the intensive care unit and monitored. Pain is
likely, and pain medication is given as appropriate. Patients also are on a
respirator and have a breathing tube for the first few hours after surgery.
The length of the hospital stay depends on how quickly a patient recovers
and can perform some physical activity.
Support Services
UT Southwestern’s cardiac rehabilitation specialists create customized plans that
integrate proper nutrition, exercise, and, if necessary,
nicotine cessation into patients’ lifestyles to improve their
cardiovascular health.
Clinical
Trials
As one
of the nation’s top academic medical centers, UT Southwestern offers a number
of
clinical trials aimed at improving the outcomes of patients with
cardiovascular disease.
Clinical trials often give patients access to leading-edge treatments that
are not yet widely available. Eligible patients who choose to participate in
one of UT Southwestern’s clinical trials might receive treatments years before
they are available to the public.