Babies and children with atrial septal defects (ASD) receive care from our team with expertise in device closure of ASD to treat their defect and reduce recovery time.

For babies and children with an atrial septal defect (ASD) — an opening in the wall between the upper chambers of the heart — a cardiac catheterization procedure can close the defect and allow blood flow to be more normal.

The expert interventional cardiology team at Johns Hopkins All Children’s in St. Petersburg, Florida, specializes in using catheter procedures to close ASD in babies and children.

What is an atrial septal defect?

The wall between the heart’s two upper chambers (the right and left atria) is called the atrial septum. When this wall has a hole in it, this is called an atrial septal defect (ASD).

The ASD causes blood to move through the hole from the left side of the heart to the right side, allowing extra blood to flow into the lungs. Over time this causes stress on the heart, and can cause the right atrium, ventricle and pulmonary arteries to become enlarged, and may lead to pulmonary hypertension, heart rhythm abnormalities, or heart failure.

An ASD is a congenital heart defect, meaning it is present at birth. There are four main types of atrial septal defects:

Secundum atrial septal defect: This is an opening in the middle part of the atrial septum. It is the most common type of ASD.

Primum atrial septal defect: The opening occurs in the lower part of the atrial septum, close to the tricuspid valve (which allows blood flow from the right atrium to the right ventricle) and mitral valve (which separates the heart’s upper and lower left chambers).

Sinus venosus atrial septal defect: The opening occurs in the upper part of the atrial septum, near the veins that flow into the right atrium.

Coronary sinus atrial septal defect: The opening occurs in the wall between the coronary sinus (a large vein that returns blood to the right side of the heart so it can pick up oxygen) and the left atrium. This is the rarest form of ASD.

Symptoms of atrial septal defects

Symptoms vary depending on the size of the opening. A smaller opening may not cause any symptoms. ASD is typically detected when your child’s doctor hears a heart murmur or abnormal heart sound in your child. 

A large opening can cause signs of heart failure, though this is rarer. Signs of heart failure may include: 

• Difficulty breathing 
• Fast breathing 
• Respiratory infection 
• Tire more easily 
• Trouble feeding 
• Poor growth 

How are atrial septal defects diagnosed?

Tests used to diagnose ASD include an echocardiogram (an ultrasound of the heart) and an electrocardiogram. A cardiac catheterization procedure (in which a small, thin tube is guided into the heart to examine the structure of the heart) may also be needed for diagnosis. 

Treatment for atrial septal defect

Treatment for ASD depends on your child’s individual condition and how much extra blood the ASD allows. In some children the ASD may be small enough that it may close on its own and only require monitoring.

For children needing treatment for an ASD, most ASDs can be closed using a cardiac catheterization procedure. The interventional cardiologist guides a long, thin tube called a catheter through the blood vessels (usually through a tiny incision in the groin area, neck or wrist), using imaging to guide the catheter and place a small device that will close the hole. 

Two devices are approved in the United States for device closure of ASD — the Amplatzer Septal Occluder and the Helex Septal Occluder. Our team has expertise in using both devices to treat ASD.

Why Choose Johns Hopkins All Children’s

The cardiac catheterization program at Johns Hopkins All Children’s is led by James Thompson, M.D., a national leader and early adopter in using the most advanced cardiac catheterization methods. Learn more about our Interventional Cardiology Program. 

The Heart Institute team includes experts in all aspects of cardiac care for children and adults with congenital heart defects, so your child can receive comprehensive care from our team through adulthood. Learn more about our Cardiology Program.