Atrial Septal Defect Transcatheter Closure In Children

WHAT YOU SHOULD KNOW:

• Atrial (A-tree-ull) septal (SEP-tull) defect transcatheter closure is also called "ASD closure". It is done to close a hole in the wall of your child's heart. ASD is a common heart defect that babies may be born with. The heart has 4 chambers or 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 left atrium blood to flow into the right atrium. Your child's 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 child's caregivers push a tiny device through the catheter and plug it into the ASD hole. The device may be shaped like a double-sided umbrella or clamshell. After the device is put in, heart tissue will grow over it in about 3 months. Your child may go home the same day or he may stay overnight in the hospital.

AFTER YOU LEAVE:

Medicines:

• Keep a written list of the medicines your child takes and when and why he takes them. Bring the list of your child's medicines or the pill bottles when your child sees his caregivers. Learn why your child takes each medicine. Ask your child's caregivers for information about your child's medicines. Do not give your child over-the-counter medicines, vitamins, herbs, or food supplements without first talking to his caregivers.
  
  
• Always give your child his medicine as directed by caregivers. Call your child's caregiver if you think your child's medicines are not helping. Call if you think your child is having side effects from the medicine. Do not stop giving a medicine until you discuss it with your child's caregiver.
  
  
• Antibiotics (an-ti-bi-AH-tiks):
  
  
  • If your child is taking antibiotics, your child must take them until they are all gone even if he feels better.
    
    
  • For the next 6 months or longer, your child may need to take antibiotics. Your child 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 child's caregiver how long your child must wait after the ASD closure before going to the dentist. Tell your child's dentist and other caregivers about your child's ASD closure.
  
  
• Blood thinners: This medicine keeps clots from forming on the ASD device and in your child's blood. Blood thinners may be given before, during, and after surgery. Blood thinners may make it easier for your child to bleed or bruise. Your child should brush his teeth with a soft toothbrush to keep his gums from bleeding.

When is my child's next doctor's appointment?

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

When can my child do his normal activity? Children usually recover from a heart cath and ASD closure very quickly. However, you must help your child be less active for at least 2 days after an ASD closure. Help your child to play quietly or lie flat as much as possible the night after the ASD closure.

• Ask your child's caregiver when he can participate in contact sports or rough play. Examples of rough play are riding bikes or tricycles, P.E. class, jumping, swinging, or heavy lifting.
  
  
• Ask your child's caregiver when he may return to school, preschool, or daycare.
  
  
• Dress your child in loose clothing for the first few days after the ASD closure. This will keep the skin around the catheter wound from being irritated (bothered) while it heals.

When can my child take a bath or shower? You may give your child a sponge bath or shower after you go home. Do not let your child take a full bath or go swimming until the scabs where catheters were put in fall off. This usually takes about 1 week. Carefully wash the catheter site with soap and water. Afterwards put on a clean, new bandage.

What can my child eat? Ask your child's caregiver if your child should be on a special diet. If your child is not on a special diet and he feels good, feed him the foods that he regularly eats. If your child is sick to his stomach, feed him only clear liquids like water, juice, or popsicles.

How do I take care of my child's catheter wound?

• It is normal for your child to have a small amount of bruising and soreness where catheters went in. This area may hurt a little bit for a few days. Watch your child's catheter bruise. Draw a line with pen around the edges of your child's catheter bruise. This will show you if the bruise starts to get bigger.
  
  
• Keep your child's catheter wound clean and dry. Change the bandage each day or whenever it gets dirty or wet. Do this until the catheter wound scabs fall off.

CONTACT A CAREGIVER IF:

• Your child's incision is swollen, red, or has pus or foul-smelling fluid coming from it. This may mean it is infected.
  
  
• Your child has a fever (increased body temperature).
  
  
• Your child has chills, a cough, or feels weak and achy. These are signs that your child may have an infection.
  
  
• Your child's skin is itchy, swollen, or has a rash. Your child's medicine may be causing these symptoms. This may mean you child is allergic (uh-LER-jik) to his medicine.
  
  
• Your child has nausea (sick to his stomach) or vomiting (throwing up) that keeps happening or gets worse.
  
  
• You have questions or concerns about your child's ASD closure, illness, or medicine.

SEEK CARE IMMEDIATELY IF:

• The bruise where the catheter went into your child gets bigger and is swollen.
  
  
• Your child's leg or arm used for the heart cath becomes numb, hurts a lot, or changes color.
  
  
• Your child becomes weak on one side of his body or face.
  
  
• Your child has trouble speaking clearly.
  
  
• Your child has a change in his vision.
  
  
• If the place where the catheter was put in starts to bleed, use your hand to put firm pressure on the bandage. Hold this pressure for 15 minutes and call your child's caregiver right away. Tell the caregiver that your child is bleeding. If you cannot stop the bleeding, call 911 or 0 (operator). This is an emergency. Ask for an ambulance to take your child to the nearest hospital or clinic.

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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