Introduction:

Atrial septal defect (ASD) closure was amongst the first cardiac operations to be performed in the early 1950s. Until recently all large ASDs were closed surgically, because of the potential long term complications if left untreated: patients may experience dilatation of the right side of the heart, abnormal heart rhythms, breathlessness, and are at risk of stroke.

More recently ASDs have been closed percutaneously (through a catheter - a long tube - inserted into a vein in the groin). A variety of different devices is now available for this technique. The procedure is done under general anaesthesia with trans-oesophageal echo guidance. It avoids open heart surgery, but does involve 3 specialists - the anesthetist, the interventionist (who actually does the procedure) and an echocardiologist. Percutaneous closure has a low complication rate, short hospital stay with next day discharge, good long term results and has been shown to be cost effective. Approximately 75 - 100 such procedures are performed in New Zealand per year. Long term follow-up studies of up to six years have shown no significant complications or death.

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