Mayo Clinic: My grandson was born with an atrial septal defect
and already has had surgery. His health care provider says he
shouldnít have any lasting problems; yet, heíll need to
have regular checkups with a cardiologist until he is an
adult. Why is this necessary? What will the cardiologist be
are several reasons why follow-up care is important for people
born with an atrial septal defect. First, checkups are used to
monitor heart function to ensure it returns to normal after
the defect is repaired. Second, because infants who have this
heart defect may be at an increased risk for developing other
heart problems, follow-up appointments are an opportunity to
catch any additional cardiac issues that may crop up.
atrial septal defect is a hole in the wall between the atria
ó the two upper chambers of the heart. Itís a congenital
condition, which means it is present when a baby is born.
atrial septal defect disrupts the flow of blood through the
heart. Usually, the right side of the heart moves blood to the
lungs. In the lungs, blood picks up oxygen. The blood then
returns to the heartís left side, where itís pumped to the
rest of the body. An atrial septal defect allows oxygenated
blood to flow from the left atrium into the right atrium.
There, it mixes with deoxygenated blood and is pumped to the
small atrial septal defects may not need treatment. When an
atrial septal defect is larger, however, the extra blood it
allows through the heart can overwork the heartís right
side. Eventually, that can cause the right side of the heart
to enlarge and weaken. Over time, it also can increase blood
pressure within the lungs and lead to pulmonary hypertension.
of an atrial septal defect in infants may include shortness of
breath; extreme sleepiness; swelling in the feet, legs or
abdomen; low appetite; and inability to gain weight.
atrial septal defects cause problems, a procedure to close the
hole is necessary. For a smaller hole, a surgeon may be able
to sew it closed. For larger atrial septal defects, a patch is
placed over the opening between the atria. In the year after
surgery, follow-up appointments typically include an
echocardiogram to confirm that the patch remains in the proper
position or monitor for leaks in the area where the atrial
septal defect was sewn closed.
atrial septal defects can be closed without surgery by placing
a device in the opening between the two atria. This device is
deployed through a catheter going through the groin blood
vessels into the heart. These devices require lifelong
follow-up to ensure correct device position and make certain
that the device is not interfering with surrounding
symptoms of an atrial septal defect often disappear shortly
after the hole is repaired, the heart doesnít return to
normal right away. It can take several years for the heartís
right side to recover completely from the blood volume
overload caused by an atrial septal defect. Checkups during
that time monitor how well the heart is working and check for
goes on, follow-up appointments become less frequent. By the
time your grandson is a teenager, he may only need checkups
about once every five years. Those checkups still are
important, though. Even when they have successful treatment as
children, as people born with an atrial septal defect age,
they can be at higher risk for developing other heart
concerns, particularly valve problems and atrial fibrillation.
Consistent follow-up care can catch problems early when they
are more easily treated.
most appropriate care once he becomes an adult, your grandson
should consult a cardiologist who has formal training in adult
congenital heart disease. That expert can develop a schedule
of additional care that best suits your grandsonís medical
news is that the outlook for children with congenital heart
defects is bright. When treated promptly ó and with
consistent follow-up care ó most people with these heart
problems go on to enjoy a healthy future and have an excellent
quality of life.