Pediatric septal defect closure

What is a pediatric septal defect closure?

Septal defect closure is a common procedure to close an opening in a baby’s heart that doesn’t close after birth. Each baby is born with an opening in the wall that separates the two upper chambers of their heart. It typically closes on its own within a few months after birth. But for some babies, the hole is large and doesn’t close. Repairing this hole is known as a septal defect closure. The majority of children don’t experience any symptoms because of the hole. However, they are at risk for heart failure when they get older if the hole remains open.

Trans-catheterization closure is the procedure we use to close the holes. We put a catheter (a thin, narrow tube) into the blood vessels in the leg. The catheter is moved toward the heart. Then, we take X-rays and ultrasound videos of the hole. After looking at these images, we’ll select the right-sized septal repair device to close the hole. The device is made up of two patches that permanently cover the hole. The lining of the heart wall will seal over the device within six months of the procedure.

We typically wait until your child is between 3 and 6 years of age to do the procedure. However, we can do the surgery before age 3 if the holes are large, and if the heart is enlarged, or if your child has had many lung infections. If necessary, we can perform a trans-catheterization closure on a child as young as 6 months.

What are the benefits of a pediatric septal defect closure?

This procedure helps prevent heart failure later in life. There are no stitches involved and most children go home the next day with very few restrictions.

What are the risks of a pediatric septal defect closure?

Usually, septal defect closure goes very well. Rarely, a child may experience a complication such as an abnormal heart rhythm, bleeding or injury to the blood vessel or heart chamber. The benefits of having the procedure far outweigh the risks.

What to expect with a pediatric septal defect closure

Our team of cardiologists, anesthesiologists and nurses at Children's Health all work together to make this procedure go as smoothly as possible.

What to expect before a pediatric septal defect closure

Usually, septal defect closure patients are referred to us by another cardiologist or a pediatrician. Because it’s not an emergency procedure, we’ll work around your schedule to find the best time to do the procedure.

Your child will be evaluated to make sure they are a good candidate for the procedure. During the evaluation appointment, you’ll learn when to stop feeding your child before the procedure, bathing recommendations, medications to take and how to schedule follow-up appointments.

What to expect during a pediatric septal defect closure

First, you’ll come to the admitting office to check-in. Then, you and your child will go to the pre-operative care unit. In this unit, you and your child will meet with the cardiologist, anesthesiologist and nurse. They can answer any last questions you may have. Your child will then be given medicine to allow them to sleep during the procedure.

We’ll invite you to sit in the waiting room during the procedure. Then, you can meet your child in the post-anesthesia care unit after the procedure is complete. From start to finish, the procedure takes less than two hours.

Usually, children stay in the hospital overnight to make sure they aren’t having any post-procedure complications.

What to expect after a pediatric septal defect closure

There are very few restrictions to expect after septal defect closure. It’s likely your child will grow and gain height and weight within the first 6 months to a year.

They’ll take a baby aspirin daily for six months after their procedure to prevent blood clots from forming on the device. The only thing we want your child to avoid is high-contact sports (such as football, hockey or rugby) for five to seven days after the procedure.

How do I prepare my child for a pediatric septal defect closure?

No matter what age your child is, we’re here to help answer any questions.

• If your child is younger than 10, we’ll have them meet with a child life specialist. A child life specialist will demonstrate how the procedure works with a teddy bear and talk about how it will help fix their heart.
• For pre-teens, we’ll sit down with them at the evaluation appointment and show them pictures of what the procedure will look like. We also explain that even though this procedure will fix their heart, they still need to come back and do follow-up appointments.
• Teenagers tend to ask us the most questions, such as, "How did this happen and why am I finding out about this now?”, “I've been playing soccer all my life. Is this going to prevent me from doing that?", or “Can’t I do this when I’m older?” Teenagers want more details on the short-term and long-term benefits. That’s why we take our time to make sure they understand the risks (of not doing the procedure) and the benefits of the procedure.

What questions should I ask my provider about a pediatric septal defect closure?

• How big is the hole in my child’s heart?
• Does the device that closes the hole stay in forever?
• What is the healing process like?
• Will there be any restrictions on my child, both in the long-term and short-term?
• After you close the hole, will my child live a normal life?
• What are the complications associated with septal defect closure?