ASD Repair

Before we are born, we have openings between the left and right sides of our hearts because the lungs are not working yet. These openings are supposed to close after we are born and using our lungs. I had a common birth defect – an Atrial Septum Defect (ASD), The openings did not fully close between the upper chambers. Due to the shunting from the left atrium to the right atrium, the doctors estimate that the right side of my heart (which goes to the lungs) was pumping about a third more blood than the left side (which goes to the rest of the body). The left side of your heart normally is filled with oxygenated blood directly from the lungs, while the right side is normally filled with blood with little oxygen. The shunt meant that the right side of my heart had an unusually high level of oxygen. As part of the body’s oxygen control mechanism, the blood vessels leading from the heart to the lungs constrict when they see high oxygen levels. Normally this status implies that the body is at rest and does not need more oxygen. Therefore, the right side of my heart was always pumping a third more blood than normal and against higher backpressure than normal due to the constricted blood vessels. It was working far too hard and was wearing out rapidly. It is enlarged -- about the same size as the left side of my heart.

As an elementary school student, I was always one of the slowest runners in my class. Perhaps this was why. In my thirties, I ran a number of large group “fun-runs” and group bike rides. I always fell behind on the hills and made it up on the downhills. I was running with a third less lung capacity than those around me.

I learned of my condition about four years ago, and had it repaired last Monday. The right side of my heart should shrink to its normally smaller size over the next few months. And I should be able to see measurable improvements in my heart rate while exercising.

The repair procedure involves inserting an ultrasonic echocardiogram device in the left femoral vein (for visualization) and various catheters in the right femoral vein. A balloon catheter is used to determine the size of the opening (see first image) and a second catheter is used to install the implant (see second image). The ultrasonic catheter (to the left) ends with a knob on it. The third image shows the installed implant disconnected from the catheters (still seen on the left). The procedure went fine, although apparently my ASD opening was in a location that was difficult to access, and the doctor struggled with getting the patch into the hole and properly located. I’ll go back in a month to have a normal (through the chest wall) echocardiogram to see if the implant is still doing its job and blocking the blood flow.One of the common symptoms of ASD is higher than normal susceptibility to lungs diseases such as pneumonia. I have never had pneumonia, but my mother and my daughter have had pneumonia many times. I now wonder if they had/have an ASD as well.