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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.
According to the National Institutes of Health, about half of all atrial septal defects eventually close on their own. About 20 percent close within the first year of life. If a hole hasn't closed early in childhood, it usually won't close on its own. Some small atrial septal defects don't cause any problems and may not need closure, but many 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 alleviate some of the signs and symptoms that can accompany an atrial septal defect. Medications may include those to:
- Keep the heartbeat regular. Examples include beta blockers (Lopressor, Inderal) and digoxin (Lanoxin).
- Increase the strength of the heart's contractions. Examples include digoxin (Lanoxin).
- Decrease the amount of fluid in circulation. Doing so reduces the volume of blood that must be pumped. These medications, called diuretics, include furosemide (Lasix).
- 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.
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.
