Atrial Septal Defect Transcatheter Closure

WHAT YOU SHOULD KNOW:

• Atrial (A-tree-ull) septal (SEP-tull) defect transcatheter (trans-KATH-uh-ter) closure (KLO-shur) is also called "ASD closure". ASD closure is done to close a hole inside your heart. ASD is a common heart defect that babies are born with. The heart has 4 chambers of rooms called the atria (A-tree-uh) and the ventricles (VEN-trik-ulls). With an ASD, there is a hole in the septum (wall) between the 2 upper chambers, the right and left atria. An ASD causes some of the blood from the left atrium to flow back into the right atrium. Your heart and lungs must work harder because of this.
  
  
• ASD closure is done during a heart catheterization (kath-uh-ter-ih-ZA-shun) or "heart cath". A heart cath is a procedure in which a catheter (long, thin, bendable tube) is gently threaded (pushed) into the heart. Your caregivers push a tiny device through the catheter and plug it over the ASD hole. The device may be shaped like a double-sided umbrella or coil. It is made of wire and mesh or cloth. After the device is put in, heart tissue will grow over it in about 3 months time. You may go home the same day or you may stay overnight in the hospital.

AFTER YOU LEAVE:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

• Antibiotics (anti-bi-AH-tiks):
  
  
  • If you are taking antibiotics, take them until they are all gone even if you feel better.
    
    
  • For the next 6 months or longer, you may need to take antibiotics. You may be given antibiotics before having dental care or medical procedures. Taking antibiotics before procedures may help prevent bacterial (bak-TEER-e-ull) endocarditis (end-o-kar-DI-tis). This is an infection in the heart. Ask your caregiver how long you must wait after the ASD closure before going to the dentist. Tell your dentist and other caregivers about your ASD and transcatheter repair.
  
  
• Aspirin: This is medicine that may be given to help thin the blood to keep blood clots from forming.
  
  
• Blood thinners: Blood thinners are medicines that help prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Blood thinners may cause you to bleed or bruise more easily. Do the following if you are taking a blood thinner:
  
  
  • Watch for bleeding from your gums or nose, or in your urine or BMs.
    
    
  • Use a soft washcloth on your skin and a soft toothbrush to brush your teeth. Doing this can keep your skin and gums from bleeding.
    
    
  • Tell your dentist before dental cleanings, and other caregivers before other procedures, that you take blood thinning medicine.
    
    
  • If you shave, use an electric shaver.
    
    
  • Do not play contact sports since you may bleed or bruise easily.
    
    
  • Wear a MedicAlert bracelet or necklace that says you are taking a blood thinner medicine. You may get one from your local drugstore or contact the MedicAlert Foundation.

When is my next doctor's appointment?

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

When can I get back to my normal activity?

• You may feel like resting for a few days after your ASD closure. Slowly start to do more each day. Rest when you feel it is needed. Keep your leg or arm straight as much as possible. For the next few days, do not bend over. Also, do not sit for more than an hour without getting up.
  
  
• Avoid lifting heavy objects. Ask your caregiver when you can start doing your usual activities again.

When can I take a bath or shower? Ask your caregiver when you may take a full bath. You may shower 24 hours after your ASD closure. Carefully wash the incision site with soap and water. Afterwards put on a clean, new bandage. Change your bandage any time it gets wet or dirty. If you cannot reach the bandage, ask someone else to help you change it.

What can I eat? Ask your caregiver before you leave the hospital if you should be eating a special diet. Eat healthy foods from all the 5 food groups: fruits, vegetables, breads, dairy products, meat and fish. Eating healthy foods may help you feel better and have more energy. It may also help you heal faster.

How do I take care of my ASD closure wound? Check the places on your groin where the catheters were put in often. It is normal to have some bruises. Draw a line with a pen around the edges of the bruises. This will show you if the bruise starts to get bigger.

How can I live the most healthy lifestyle?

• Colds and Flu: Stay away from people who have colds or the flu. Get shots to keep from getting the flu and pneumonia (new-MOAN-yuh). Also try to stay away from large groups of people. This decreases your chance of getting sick or getting an infection.
  
  
• Drinking liquids: Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Good choices for most people to drink include water, juice, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Some food items such as soup and fruit also add liquid to your diet. Ask your caregiver how much liquid you should have each day.
  
  
• Exercise: Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you. It is best to start slowly and do more as you get stronger. Exercising makes the heart stronger, lowers blood pressure, and keeps you healthy.
  
  
• Quit smoking: It is never too late to quit smoking. Smoking harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.
  
  
• Stress: Stress may slow healing and cause illness later. Since it is hard to avoid stress, learn to control it. Learn new ways to relax, such as deep breathing, meditation, relaxing muscles, music, or biofeedback. Talk to someone about things that upset you.

CONTACT A CAREGIVER IF:

• Your incision is swollen, red, or has pus coming from it. This may mean it is infected.
  
  
• You have a fever (increased body temperature).
  
  
• You have chills, a cough, or feel weak and achy. These are signs that you may have an infection.
  
  
• Your skin is itchy, swollen, or has a rash. Your medicine may be causing these symptoms. This may mean you are allergic (uh-LER-jik) to your medicine.
  
  
• Your heart feels like it is beating too fast and is not beating regularly. You faint or feel dizzy, weak, short of breath, or have chest pain while this is happening.
  
  
• You have questions or concerns about your ASD closure, illness, or medicine. Call if your ASD symptoms come back after the ASD closure.

SEEK CARE IMMEDIATELY IF:

• The bruise where the catheter went into your groin, arm, or neck gets bigger.
  
  
• You have trouble breathing all of a sudden. This could be a sign that you have a blood clot in your lung. It could also mean that you are allergic to a medicine you are taking.
  
  
• Your leg or arm used for the heart cath becomes numb, hurts a lot, or changes color.
  
  
• You have weakness or numbness on one side of your body or face. This could be a sign of a stroke.
  
  
• If the place where the catheter was put starts to bleed, use your hand to put firm pressure on the bandage. Hold this pressure for 30 minutes. Call your caregiver to tell him/her that you are bleeding. If you cannot stop the bleeding, call 911 or 0 (operator) for an ambulance to take you to the nearest hospital or clinic. Do not drive yourself!

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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