ASD/VSD/PFO/PDA/PVL closure

ASD/VSD/PFO/PDA/PVL closure

The percutaneous closure procedure is a treatment option that can be used to repair abnormal openings in the heart. It can also be used to repair gaps around prosthetic valves that result after surgery.

This minimally invasive procedure involves carrying a repairing device through a vein in the leg up to the heart. For some patients, it can be a suitable alternative to open heart surgery — a decision that must be made after careful consultation and assessment with your doctors and treating specialists. This can include input from both neurologists and cardiologists.


Atrial and ventricular septal defects

Commonly referred to as a ‘hole in the heart’, arterial and ventricular septal defects are heart abnormalities generally present from birth. They are an abnormal opening in the heart that didn’t close during development or after birth.


These conditions include:

  • Atrial septal defect (ASD): An opening in the wall dividing the upper chambers (atria) of the heart.
  • An ultrasound probe (transoesophageal echocardiogram probe) is placed down your oesophagus to visualise the heart.
  • Ventricular septal defect (VSD): An opening in the wall dividing the lower chambers (ventricles) of the heart.
  • Patent foramen oval (PFO): An opening in the wall between the upper right and left chambers of the heart that doesn’t close properly after birth.
  • Patent ductus arteriosus (PDA): A hole in the heart’s main artery (aorta) that doesn’t close properly after birth.

Depending on the size of the opening, it is not uncommon for these conditions to go for many years or decades without being noticed. However, in some cases, they can cause stress on the heart and result in symptoms such as breathlessness, stroke, or abnormal heart enlargement.

For some patients, open heart surgery may be the best option to repair these openings. For others, a percutaneous closure may be recommended.


Percutaneous closure procedure

The percutaneous closure procedure can be used to repair ASD, VSD, PFO and PDA. It can also be used to repair paravalvular leaks (PVL) — gaps between prosthetic valves and heart tissue.

Repair devices may look slightly different, depending on the type of closure being performed. Most are made of titanium nickel alloy. While the devices have slight variations, the closure procedure is the same. During a percutaneous closure:

  • A general anaesthetic will be administered, including being put on a breathing machine to support your breathing.
  • An ultrasound probe is placed down your oesophagus to visualise the heart.
  • A tube (sheath) is inserted in the vein (and sometimes artery, depending on the heart abnormality being treated) in your leg.
  • Through the tube in your leg, a delivery wire is used to carry the repairing device up to the heart under ultrasound and X-ray guidance.
  • The device is positioned and the closure is performed.
  • All wires and tubes are removed from your body, and a stitching device is used to close up the hole in your vein (and/or artery).

The information here is for general reference only. To understand the benefits and risks specific to your condition and overall situation, please discuss the procedure with your treating doctor.

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