Implantable Closure Device

Treating Cardiovascular Diseases in Wisconsin and Northern Illinois

Physicians may choose to use an implantable closure device to treat certain heart diseases, such as atrial septal defect. An atrial septal defect (ASD) is a congenital heart defect; something you were born with.  The ASD is a small hole in the atrial septum, the tissue that separates the right and left atria, which are the two upper chambers of the heart.

There are several types of ASD’s and they are classified by where in your atria they occur, and how big the hole is. This hole in the heart may or may not cause you problems throughout your life.  The ASD often goes unnoticed for many years because the physical signs can be mild. However, as you age, symptoms can become more severe and if left untreated, you may have symptoms of heart failure such as shortness of breath, fatigue or pulmonary hypertension. Patients with ASDs are also at risk for stroke or other problems.

If your doctor feels that the ASD may or has caused you problems, one of the ways it can be treated is to go through a blood vessel in your leg with a closure device.  Sometimes surgery is needed instead.  Your doctor will decide if using a closure device is right for you.

The closure device will help seal or close the hole in your heart by using what looks like two small mesh umbrellas. The device is attached to a special catheter which is inserted into a vein in your leg and then advanced into your heart. Your doctor locates the hole in your heart with the help of an ultrasound camera. Once the hole is found, the closure device is advanced out of the catheter to seal the hole.

Over time, the tissue around the hole grows into the mesh of the device and the implant becomes a permanent part of your heart.

How to Prepare for a Cardiac Implant Closure Device Procedure

Your doctor will need to do some testing prior to your procedure to determine if the ASD can be treated percutaneously through a vein, or if it requires surgery.  Some of these tests may include a cardiac catheterization, echocardiogram and EKG. Other tests may also be ordered.  Your doctor will decide which tests are right for you.  If the doctor determines to treat you with a percutaneous approach, there are a few things you will need to know. 

To prepare for your ASD closure, your doctor is likely to ask you to stop taking any blood thinner medication you might be on and possibly other medication before the procedure.  Please bring all of your home medications with you, including over-the-counter.

When you arrive for your appointment, please tell your nurse if you have been taking blood thinner medication, diuretics (water pills) or insulin.  Also tell the staff if you are allergic to anything, especially x-ray dye, penicillin-type medications, and latex or rubber.  The doctor will give you specific instructions about what you can or cannot eat or drink before the procedure.  Depending on the time of your procedure, you may be asked not to eat or drink anything after midnight the night before.

Even though an ASD closure procedure takes usually one hour to perform, you should plan on staying at the hospital overnight.   You will also be asked to arrive up to three hours before your scheduled procedure time because there are many things that need to be done to get you ready for your procedure.  Once you arrive at the hospital you will be taken to your pre-procedural room and you will be asked to change into a hospital gown so that we can prepare you for the procedure.  

Some of the things we must do to prepare you for your procedure may include drawing the blood work your doctor has ordered and starting IV fluids to help protect your kidney function.  The staff will start an IV line in your arm so that we can give you IV fluids before and during the procedure.  You may also have an EKG or chest x-ray done.  Your caregiver may need to clip or shave some of your body hair in the area that the doctor will be working on you.  We keep you covered as much as possible, but please tell us if you are uncomfortable at any point.

Once all the labs, IV’s and x-rays are done, and you have changed into a gown, you will then be ready for the procedure.  Most of the time your procedure will go as scheduled.  Sometimes, there might be a delay due to an unexpected event.  If this happens, we will keep you informed and we will try and make you as comfortable as possible until you go for your procedure.

What to Expect During a Cardiac Implant Closure Device Procedure

When you enter the cath lab, you will be wearing a hospital gown. so we will give you warm blankets to help keep you comfortable. You will be asked to lie on a narrow table and we will put some safety straps around you to keep you safe.  We will attach EKG patches to your chest to monitor your heartbeat during the procedure. We will then wash and clip hair from the area that your doctor will be working from.  Your blood pressure will also be checked at intervals throughout.

You may be put to sleep for this procedure. Yyour doctor will determine what type of anesthesia to use.  The doctors will use a special machine to take pictures of your heart.  This is called a Transesophageal Echo and is done with a tube that the doctor puts down your throat to view the atria.  You should not feel this.  You will also have x-ray pictures taken.  A large camera and several TV monitors hang above the procedure table to view the images of your heart.   A doctor will also numb the groin where he will be placing a sheath into the vein in your leg.  The sheath is like a long IV.  This is the place where the doctor will guide equipment into the blood vessel.

Next, a catheter is inserted through the sheath, advanced to the atrial septum in the heart, and pushed through the ASD hole.  When the catheter is in the proper position, the device is slowly pushed out of the catheter until a small disc sits on each side of the defect, like a sandwich. The discs are filled with polyester fabric to increase the device’s closing ability. The two discs are linked together and over time, heart tissue grows over the implant, and it becomes a permanent part of the heart.

Recovery after the Cardiac Implant Closure Device Procedure

Again, you will stay overnight.  The next day you may have another Echo done.  You will likely then be discharged home.  Typically you will see your doctor for follow up in about six months.  Before you go home you will be instructed on activity restrictions and any other special restrictions. 

Risks and Side Effects of a Cardiac Implant Closure Device Procedure

Some of the risks associated with this procedure include, but are not limited to, bruising, sore throat, chest pain, palpitations, stroke, bleeding, infection, and death.  Your doctor will go over the risks and benefits of the procedure with you in more detail. 

Why Choose Aurora for a Cardiac Implant Closure Device Procedure?

The cardiologists here at Aurora that perform these procedures are specially trained and considered experts in their field.  Some of the physicians are utilized as proctors for training other physicians across the country to perform these procedures.  In addition, our nursing and technical staff are experts in the care of this type of patient. 

Aurora doctors are conveniently located throughout eastern Wisconsin and northeastern Illinois. Find a doctor or vascular specialist near you. To get a second opinion or if you need assistance finding a provider, please call 888-649-6892.