Atrial Septal Defect


An atrial septal defect (ASD) is often referred to as a “hole in the heart”. It occurs when there is an abnormal opening in the septum that divides the two upper chambers of the heart. This opening allows blood from either side of the heart to cross into the opposite atrium.

Usually, because the left side of the heart is at a higher pressure than the right side, blood from the left atrium will flow to the right atrium and can end up in the lungs.  This is called a left-to-right shunt. Because the right side of the heart and the blood vessels in the lungs are not built to withstand increased volumes and pressures, left-to-right shunting may result in heart failure and heart rhythm problems.

Patients can be seen by Texas Children's experts in Heart Center.

Symptoms & Types

ASD signs and symptoms depend on the size and the amount of blood that flows abnormally across the defect. Symptoms may include:

  • Breathing difficulties
  • Frequent respiratory infections
  • Enlarged heart
  • Irregularities in heart rhythm (dysrhythmias), especially atrial dysrhythmias
  • Heart failure

Diagnosis & Tests

Tests to diagnose atrial septal defect may include:

  • Chest X-ray
  • Electrocardiogram (EKG)
  • Echocardiogram

Treatment & Care

Atrial septal defect closure is the treatment procedure for ASD and can be closed with open-heart surgery or in a less invasive interventional procedure in the Cardiac Cath Lab. The heart has to be opened, and the patient’s blood flow is diverted to a heart-lung bypass machine during the repair.  

Trained to Treat For certain children undergoing ASD repair, Texas Children’s Heart Center offers a minimally invasive approach in which the incision is significantly shorter than the standard sternotomy incision. If the patient has no other cardiac defects, this operation usually is considered a cure and no further operations should be needed.

Volumes & Outcomes