What is an atrial or ventricular septal defect repair?

An atrial or ventricular septal defect repair closes a hole in the heart’s septum. A septum, or wall, separates the two top chambers, or atria, and the two bottom chambers, or ventricles. Your doctor will sew the hole closed or patch the hole with your own tissue or a synthetic patch. 

Septal defects are congenital defects that are often diagnosed at birth or shortly after birth. Symptoms of septal defects may not appear in some people until childhood or even adulthood. Symptoms include shortness of breath, fatigue, weakness, and a heart murmur. Left untreated, a septal defect can lead to an enlarged heart, heart failure, and high blood pressure in the lungs (pulmonary hypertension).

Small septal defects may close without treatment or may not pose a health risk. Larger holes that cause symptoms or put you at risk of complications require treatment. A septal defect repair can relieve symptoms and prevent complications and irreversible heart and lung damage.

An atrial or ventricular septal defect repair is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having an atrial or ventricular septal defect repair. 

Why is an atrial or ventricular septal defect repair performed? 

Your doctor may recommend an atrial or ventricular septal defect repair to treat a hole in your heart’s septum. Your doctor will only consider an atrial or ventricular septal defect repair for certain types of defects. Ask your doctor about all of your treatment options and consider getting a second opinion. 

Regardless of whether you have symptoms or not, your doctor may recommend an atrial or ventricular septal defect repair based on the following: 

  • Size and location of the septal defect
  • Degree that it affects normal blood flow
  • Degree of pulmonary hypertension 

Who performs an atrial or ventricular septal defect repair?

A cardiac surgeon or an interventional cardiologist performs an atrial or ventricular septal defect repair. Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons. Interventional cardiologists specialize in diagnosing and treating heart disease using catheter procedures and radiological imaging.

If your child needs an atrial or ventricular septal defect repair, a pediatric cardiac surgeon or pediatric interventional cardiologist will perform the procedure.

How is an atrial or ventricular septal defect repair performed?

Your atrial or ventricular septal defect repair will be performed in a hospital. Your doctor will sew the hole closed or patch the hole with your own tissue or a synthetic patch. Closing the hole in your heart can involve open-heart surgery, minimally invasive techniques, or a cardiac catheter-based procedure.

If you are a candidate for a catheter-based procedure, your cardiologist will insert a catheter and guide wire through an incision in your groin. The doctor feeds the catheter into the heart chamber with the hole. Your doctor will plug the hole with a device that remains in place. With time, your body will grow tissue over the device.

Surgical approaches to an atrial or ventricular septal defect repair

If you require surgery, your doctor will perform your atrial or ventricular septal defect repair using one of the following approaches:

  • Minimally invasive surgery is also known as a mini-thoracotomy. It involves making a small, three-inch incision in the side of your chest. Your surgeon uses special instruments to repair your septal defect through this small incision. A heart-lung bypass machine is necessary for this surgery. Your surgeon provides access to the heart-lung machine through another incision in your groin. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your doctor will make a small incision instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery. 
  • Robot-assisted endoscopic surgery involves several tiny porthole incisions between your ribs. Your cardiac surgeon uses a robot and inserts special instruments and a thoracoscope through these incisions. A thoracoscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your body to a video screen viewed by your doctor while performing the surgery. Like minimally invasive surgery, endoscopic surgery involves a faster recovery and less pain than open surgery.
  • Open-heart surgery involves making a large incision in the front of your chest and breastbone. Open surgery allows your doctor to directly see and access the surgical area. A heart-lung bypass machine is necessary for this surgery. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.