What It Is
The septum is a wall that separates the heart's left and right sides. Septal defects are sometimes called a "hole" in the heart. A defect between the heart's two upper chambers (the atria) is called an atrial septal defect (ASD).
When there is a large defect between the atria, a large amount of oxygen-rich (red) blood leaks from the heart's left side back to the right side. Then this blood is pumped back to the lungs, despite already having been refreshed with oxygen. This is inefficient, because already-oxygenated blood displaces blood that needs oxygen. Many people with this defect have few, if any, symptoms.
Closing an atrial septal defect in childhood can prevent serious problems later in life. The long-term outlook is excellent. If atrial septal defects are diagnosed in adulthood, the defect is also repaired. Rarely, the defect is left unrepaired if there's pulmonary hypertension (high blood pressure in the lungs). Your cardiologist can determine if the defect should be closed.
After an ASD is closed, patients need follow-up with a cardiologist. Only rarely will they need to take medicine. Your cardiologist can monitor you with noninvasive tests if needed. These include electrocardiograms, Holter monitors, exercise stress tests and echocardiograms. They will help show if more procedures, such as a cardiac catheterization, are needed.
Activity restrictions are almost never needed unless there are associated problems that you and your doctor have discussed.
Problems You May Have
People with repaired atrial septal defects rarely have any problems. Those who have palpitations or faint need to be reevaluated by their cardiologist and may need medical therapy. Also, if the ASD is diagnosed late in life, the heart may be less able to pump. This can require diuretics, drugs to help the heart pump better and drugs to control blood pressure. If pulmonary hypertension develops (which is rare), some people may need more medications.
Will You Need More Surgery?
Once an ASD has been closed, it's unlikely that more surgery will be needed. Rarely, a patient may have a residual hole. Whether it will need to be closed depends upon its size.