Did your doctor recently mention something called an Atrial Septal Defect (ASD)? Or perhaps your child was diagnosed with it during a routine check-up? If so, don’t panic, you are not alone, and the good news is, this condition is treatable. An ASD is a hole in the wall that separates the two upper chambers of the heart. While some small ASDs may close on their own, larger ones often require atrial septal defect surgery to prevent long-term complications.
In this blog, we will walk you through what ASD is, when surgery is needed, what the procedure looks like, and most importantly, how recovery happens and how successful these surgeries really are.
Let’s break it down, step by step.
What is Atrial Septal Defect (ASD)?
An ASD is a congenital heart defect, which means you are born with it. Essentially, it’s a hole in the wall (called the septum) that separates the heart’s upper chambers; the left and right atria.
Normally, this wall stops oxygen-rich blood from mixing with oxygen-poor blood. But when there’s a hole, the blood can mix, which puts a strain on the heart and lungs.
What are the Different Types of ASD?
There are a few different kinds of ASDs, depending on where the hole is located:
- Secundum ASD: The most common type, found in the middle part of the septum.
- Primum ASD: Located lower in the septum and often linked with other heart issues.
- Sinus Venosus ASD: Found near the veins that bring blood back from the lungs.
- Coronary Sinus ASD: A very rare type, near the vein called the coronary sinus.
What are the Causes and Risk Factors of Atrial Septal Defect?
The exact cause isn’t always known, but genetics, environmental factors, and certain conditions during pregnancy (like uncontrolled diabetes or infections) may play a role.
Common Symptoms of Atrial Septal Defect
ASD symptoms often show up differently in kids and adults:
- In children: Fatigue during play, frequent respiratory infections, poor weight gain.
- In adults: Shortness of breath, palpitations, swelling in legs, or even stroke.
When is Atrial Septal Defect Surgery Recommended?
Not all ASDs need surgery. Very small holes can close on their own or may never cause problems. But moderate to large ASDs? They usually need to be fixed.
Surgery is recommended when:
- the ASD is causing symptoms.
- there is a risk of complications like heart failure or pulmonary hypertension.
- the heart is enlarged or overworked.
- there is a history of stroke due to blood clots passing through the hole.
What about age?
- In infants, surgery is usually delayed unless symptoms are severe.
- In children, elective closure is often done between ages 2–5.
- In adults, surgery can still be effective, even in later life.
The earlier it’s fixed, the better the heart can recover and function normally.
What are the Different Types of Atrial Septal Defect Surgery?
Depending on the size and type of the defect, your doctor might recommend one of these approaches:
Open-Heart Surgery
This is the traditional method, especially for large or complex ASDs.
- Procedure: The chest is opened, and a heart-lung machine takes over the job of pumping blood. The surgeon then patches or stitches the hole.
- Used for: Primum, sinus venosus, or very large secundum ASDs.
- Pros: Long-term success.
- Cons: Longer recovery, more invasive.
Minimally Invasive Surgery
This method uses smaller cuts and often a video-assisted approach.
- Procedure: Small incisions are made between the ribs. The same patch or stitches are used, but without opening the full chest.
- Pros: Less pain, faster healing.
- Cons: Not suitable for all types of ASD.
Catheter-Based Closure (Non-Surgical)
Also known as transcatheter closure, this is the least invasive option.
- Procedure: A thin tube (catheter) is inserted through a vein in the leg and guided to the heart. The specialist places the device to plug the hole.
- Used for: Medium-sized secundum ASDs.
- Pros: No incision, short hospital stay.
- Cons: Not suitable for all ASDs or very large holes.
Step-by-Step Atrial Septal Defect Surgery Procedure
Wondering what the actual process looks like? Here’s a simple breakdown:
Pre-surgical Evaluation
Before surgery, doctors will run tests like:
- Echocardiogram (ultrasound of the heart)
- MRI or CT scans
- Blood work
- Cardiac catheterization (in some cases)
Anesthesia and Prep
The anesthesiologist will give you general anesthesia so you are completely asleep and pain-free. Your healthcare team will sterilize your chest area and prepare it for surgery.
Surgical Process
- For open-heart surgery, the chest is opened, and a heart-lung machine is used.
- Your surgeon will either stitch close or patch the hole with a synthetic or tissue graft.
- For catheter-based closure, the device is placed through a vein using imaging to guide it.
Post-Surgery Care
Right after surgery, you will spend some time in the ICU. Your healthcare team will closely monitor your heart rhythm, oxygen levels, and blood pressure .
Recovery After Atrial Septal Defect Surgery
The recovery timeline depends on the type of surgery:
Hospital Stay
- Open-heart surgery: 5–7 days
- Minimally invasive surgery: 3–5 days
- Catheter-based closure: 1–2 days
Physical Activity
You will need to take it easy for a few weeks:
- No heavy lifting or strenuous exercise for 4–6 weeks
- Children can usually return to school within 2–3 weeks
- Adults can resume work after 4–6 weeks (depending on job type)
Pain Management
Some chest discomfort or soreness is normal, especially after open surgery. Medications help manage this.
Signs to Watch For
Call your doctor if you notice:
- Fever or chills
- Redness or discharge at incision sites
- Chest pain or difficulty breathing
- Abnormal heartbeat
Follow-up Care
You might require:
- Routine echocardiograms
- Possibly a heart monitor
- Medications for a short time (like blood thinners or antibiotics)
Success Rate of Atrial Septal Defect Surgery
Here’s the best part: ASD surgery is highly successful!
- Success rate: Over 95% in children and 90–95% in adults
- Long-term results: Most people live completely normal lives post-surgery
- Lower risk of complications: Once closed, the risk of stroke or heart failure drops drastically
What Affects the Outcomes of Atrial Septal Defect Surgery?
The following factors might affect the outcomes of ASD surgery:
- Age at surgery (earlier is better)
- Size and type of the defect
- Overall heart function
- Presence of other heart conditions
What are the Risks and Potential Complications of Atrial Septal Defect Surgery?
Like any procedure, ASD surgery carries some risk. However, complications are relatively rare.
Common Risks
- Bleeding
- Infection
- Arrhythmias (irregular heartbeats)
- Reaction to anesthesia
Rare Complications
- Blood clots
- Device migration (in catheter-based procedures)
- Pericardial effusion (fluid around the heart)
How Common are the Risks and Complications?
In skilled hands, major complications occur in less than 2–3% of cases. Most are minor and manageable.
Prevention Tips:
- Choose a reputed cardiac center
- Stick to follow-up schedules
- Take medications exactly as prescribed
Life After Atrial Septal Defect Surgery
After full recovery, most people can live completely normal, active lives with:
- better exercise tolerance,
- less fatigue and breathlessness, and
- no more risk of stroke from heart-related clots.
Medications After Atrial Septal Defect Surgery
Some patients might need:
- Antibiotics before dental work (to prevent infection)
- Blood thinners for a few months (especially if a device was used)
In most cases, long-term medication isn’t needed.
Cost of Atrial Septal Defect Surgery
The cost of ASD surgery varies by country and the type of procedure:
| Country | Estimated Cost |
| India | USD 5,000 – USD 6,500 |
| Turkey | USD 6,000 – USD 10,000 |
| UAE | USD 10,000 – USD 15,000 |
| USA | USD 30,000 – USD 60,000 |
Tip: Many patients choose medical tourism facilitators like EdhaCare to access high-quality care at lower costs, especially in India.
Conclusion
An atrial septal defect may sound scary at first, but the reality is that it’s highly treatable. Whether your child or you need surgery, modern procedures make recovery smooth and outcomes excellent.
From catheter-based closure to open-heart repair, the options are safer than ever. Recovery takes a few weeks, and once healed, life truly goes back to normal.
If you or your loved one has been diagnosed with ASD, the best next step is to talk to a heart specialist. Early action leads to the best results.
Frequently Asked Questions (FAQs)
Is ASD surgery safe for children?
Yes. It’s a routine procedure with excellent safety and success rates, especially when done early.
Will the defect come back after surgery?
No. Once repaired properly, the defect does not return. Follow-up checks confirm closure success.
Can I live a normal life after ASD surgery?
Absolutely. Most people go on to live active, healthy lives without limitations.
Is ASD a major surgery?
Yes, ASD closure is considered a major surgery, especially if it involves open-heart techniques. However, the cardiologists and cardiac surgeons can also perform ASD surgery using less invasive and minimally invasive procedures.
Which surgery is best for ASD?
The best surgical option for ASD typically depends on the specific characteristics of the defect and the patient’s health. Surgical closure and catheter-based techniques are both effective.