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Cardiac Sciences

Closure of “Holes” in the Heart without Surgery

admin Apr 10, 2023

Some children are born with ‘Holes’ in the heart. These could be abnormal communications in the upper partition of the heart i.e. atrial septal defect (ASD) or in the lower partition of the heart i.e. ventricular septal defect or between the two great arteries i.e. patent ductus arteriosus and AP window. These ‘holes’ cause extra blood to flow from the left side of the heart to the right side of the heart and ultimately to the lungs. If this flow is significant it makes the lungs prone to repeated lower respiratory tract infections, this interferes with the normal growth of the child. Additionally the extra blood on right side results in enlargement of the heart chambers and may cause elevation of pulmonary artery pressures and heart failure. As such if the abnormal flow is significant these “Holes” should be closed. Till few years back all these ‘Holes’ had to be closed by operation of the heart. Now a days with the technical advances and expertise of the cardiologist these holes can be closed without surgery. From the groin small tubes (cardiac catheters) are put in the artery and veins to perform angiography and via these tubes coils (stain less steel) or devices (Nitinol) are inserted to close these holes. These umbrella shaped devices close the hole and get layered by body tissue(reendothelized) within few months. The results of this technique are almost 100% with minimal risk. These are no scars and the patient can go home walking next day. Long term results are excellent with no restriction of activity and growth of the baby similar to as compared to normal child of the age.

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