We will do a special echocardiogram called a
Transesophageal Echocardiogram (TEE). This test will tell us if your atrial septal defect (ASD) is suitable for occluder closure.
Once the results of your TEE are available, the doctor will meet with you to talk about the procedure and tell you about the risks and alternative treatments. You'll have an opportunity to ask questions.
If you decide to go ahead, we will give you an appointment for the procedure and book you to attend the Pre-Admission Cardiology Clinic. Here you will meet one of our nurses and have blood work done to prepare you.
How to Prepare
Please do not eat or drink anything for 6 to 8 hours before your ASD Closure.
Please bring with you a list of your current medications. This includes prescription medications, over-the-counter medications, vitamin or mineral supplements and herbal remedies.
A friend or family member is required to be present in the lab during the procedure. You will be sedated during this procedure. The friend or family member will be instructed on how to care for you after the procedure and be required to drive and/or accompany you home. They can also help you gather information, take notes and ask questions.
Checking In
Your procedure will be done in the
Cardiovascular Investigations Unit but you will be admitted to the Cardiac Short Stay Unit on the 5th Floor Munk Building on the morning of your procedure.
When you arrive at the Cardiac Short Stay Unit, check in at the reception desk. Please have the following ready:
- Health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID (such as a driver's license, passport, or other provincial health card). Please arrive 15 minutes before your appointment.
- Your name, address and birth date
Your procedure will be done shortly after you arrive. Your doctor will see you at that time.
Before the ASD Closure
When you check-in, the receptionist will give you a name band to wear. You will be assigned a room to wait and asked to change into a hospital gown. Your family should keep your valuables with them.
A nurse will prepare you for the procedure by reviewing a checklist, starting an IV and confirming your medications. When it's time for your procedure an attendant will take you down to the Cardiovascular Investigations Unit.
During and After the ASD Closure
We'll do your procedure under local anesthetic in the groin area, but we also give you a sedative and painkiller intravenously to keep you relaxed and comfortable. We'll put a small catheter or tube into the vein at the groin site and pass it into the right atrium on the right side of the heart, then through the defect to reach the left atrium.
We measure the size of the defect using a special inflatable balloon, which is positioned in the defect. The size of the occluder is then chosen to fit your defect exactly.
The occluder is attached to a delivery system and folded so that it can fit within the tube positioned in the heart. Then the occluder is passed along the tube until it goes through the defect. One disc is opened on the left atrial side of the defect, and the other disc is opened on the right atrial side. This completely covers the hole like a patch, with the central waist joining the two discs actually plugging the defect.
Following the ASD Closure
After you're awake, the doctor will discuss the outcome of the procedure with you. We'll tell your family when it's done, and they can see you after the procedure is over.
You will be discharged from the hospital the next morning, and you'll have an echocardiogram before you go.
Follow-up after Discharge
You will be scheduled for a follow-up appointment 8 - 12 weeks after your procedure. Your appointment will be in the
Adult Congenital Cardiac Clinic. After that, your own cardiologist can follow you. Routine
electrocardiogram and
echocardiogram will be done from time to time as part of your follow-up
How Long Will the Procedure Take?
The procedure usually takes 30 to 45 minutes.
We do everything that we can to stay on time. Unfortunately, your procedure may be delayed by unforeseen circumstances. We recommend that you come prepared for delays.
